14D2054741 CLIA NUMBER - SPRINGFIELD SUITES REHAB & NURSING LLC

Laboratory Demographics

  • CLIA Code: 14D2054741
  • Facility Name: SPRINGFIELD SUITES REHAB & NURSING LLC
  • Facility Address: 3089 OLD JACKSONVILLE RD
    SPRINGFIELD, IL
    ZIP 62704
  • Facility Phone: 845 414-3300
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: CHAIM MILLMAN
  • NPI Number: 1447592118
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 14D2054741
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name SPRINGFIELD SUITES REHAB & NURSING LLC
Street 3089 OLD JACKSONVILLE RD
City SPRINGFIELD
State IL
ZIP 62704
Phone 845 414-3300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/27/2025
Certificate Expiration Date 2/26/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director CHAIM MILLMAN

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