14D1062956 CLIA NUMBER - EMERALD ESTATES

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CLIA Record

Field Name Field Value
CLIA Number 14D1062956
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name EMERALD ESTATES
Street 1577 E MYRTLE
City CANTON
State IL
ZIP 61520
Phone 309 647-6604
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/2/2025
Certificate Expiration Date 1/1/2027
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director NICKI PALMER

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This page was last updated on: 9/29/2025