14D1089631 CLIA NUMBER - FOUNTAIN VIEW MANOR MEMORY CARE

Laboratory Demographics

  • CLIA Code: 14D1089631
  • Facility Name: FOUNTAIN VIEW MANOR MEMORY CARE
  • Facility Address: 3432 VILLAGE LANE
    GRANITE CITY, IL
    ZIP 62040
  • Facility Phone: 618 931-3999
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: CYNTHIA BURROWS
  • NPI Number: 1871741462
  • Taxonomy: 311500000X - Alzheimer Center (Dementia Center)

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CLIA Record

Field Name Field Value
CLIA Number 14D1089631
LAB Type Assisted Living Facility
Facility Name FOUNTAIN VIEW MANOR MEMORY CARE
Street 3432 VILLAGE LANE
City GRANITE CITY
State IL
ZIP 62040
Phone 618 931-3999
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/23/2024
Certificate Expiration Date 9/22/2026
Facility Type Assisted Living Facility
Lab Director CYNTHIA BURROWS

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