14D2021034 CLIA NUMBER - SHELBYVILLE COMMUNITY MEDICAL CENTER CONSOLIDATED COMMUNITY MEDICAL CENTERS SC

Laboratory Demographics

  • CLIA Code: 14D2021034
  • Facility Name: SHELBYVILLE COMMUNITY MEDICAL CENTER CONSOLIDATED COMMUNITY MEDICAL CENTERS SC
  • Facility Address: 249 N MORGAN ST
    SHELBYVILLE, IL
    ZIP 62565
  • Facility Phone: 217 774-2900
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DOMINIC C. IMBURGIA MD
  • NPI Number: 1912530189
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 14D2021034
LAB Type Physician Office
Facility Name SHELBYVILLE COMMUNITY MEDICAL CENTER CONSOLIDATED COMMUNITY MEDICAL CENTERS SC
Street 249 N MORGAN ST
City SHELBYVILLE
State IL
ZIP 62565
Phone 217 774-2900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/4/2025
Certificate Expiration Date 3/3/2027
Facility Type Physician Office
Lab Director DOMINIC C. IMBURGIA MD

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