14D2090501 CLIA NUMBER - COMMUNITY RESOURCE CENTER

Laboratory Demographics

  • CLIA Code: 14D2090501
  • Facility Name: COMMUNITY RESOURCE CENTER
  • Facility Address: 580 EIGHTH ST
    CARLYLE, IL
    ZIP 62231
  • Facility Phone: 618 594-4581
  • Facility Type: Other - OTPT SUBSTANCE ABUSE CTR
  • Facility Type: Waiver
  • Lab Director: GEORGIANNE BROUGHTON
  • NPI Number: 1154599884
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2090501
LAB Type Other - OTPT SUBSTANCE ABUSE CTR
Facility Name COMMUNITY RESOURCE CENTER
Street 580 EIGHTH ST
City CARLYLE
State IL
ZIP 62231
Phone 618 594-4581
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/26/2025
Certificate Expiration Date 1/25/2027
Facility Type Other - OTPT SUBSTANCE ABUSE CTR
Lab Director GEORGIANNE BROUGHTON

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