14D2003064 CLIA NUMBER - TAZEWELL COUNTY JAIL MEDICAL DEPARTMENT

Laboratory Demographics

  • CLIA Code: 14D2003064
  • Facility Name: TAZEWELL COUNTY JAIL MEDICAL DEPARTMENT
  • Facility Address: 101 S CAPITOL ST
    PEKIN, IL
    ZIP 61554
  • Facility Phone: 309 477-2786
  • Facility Type: Other - COUNTY JAIL
  • Facility Type: Waiver
  • Lab Director: JESSICA A. BONNETTE
  • NPI Number: 1487856944
  • Taxonomy: 251300000X - Local Education Agency (LEA)

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CLIA Record

Field Name Field Value
CLIA Number 14D2003064
LAB Type Other - COUNTY JAIL
Facility Name TAZEWELL COUNTY JAIL MEDICAL DEPARTMENT
Street 101 S CAPITOL ST
City PEKIN
State IL
ZIP 61554
Phone 309 477-2786
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/2/2023
Certificate Expiration Date 12/1/2025
Facility Type Other - COUNTY JAIL
Lab Director JESSICA A. BONNETTE

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