14D2142419 CLIA NUMBER - FAIRFIELD SENIOR LIVING & REHAB LLC

Laboratory Demographics

  • CLIA Code: 14D2142419
  • Facility Name: FAIRFIELD SENIOR LIVING & REHAB LLC
  • Facility Address: 305 NW 11TH ST
    FAIRFIELD, IL
    ZIP 62837
  • Facility Phone: (618) 294-8696
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: SCOTT STOUT
  • NPI Number: 1639907264
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 14D2142419
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name FAIRFIELD SENIOR LIVING & REHAB LLC
Street 305 NW 11TH ST
City FAIRFIELD
State IL
ZIP 62837
Phone 6182948696
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/10/2026
Certificate Expiration Date 1/9/2028
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director SCOTT STOUT

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This page was last updated on: 5/18/2026