14D2143643 CLIA NUMBER - CHRISTIAN COUNTY SHERIFF

Laboratory Demographics

  • CLIA Code: 14D2143643
  • Facility Name: CHRISTIAN COUNTY SHERIFF
  • Facility Address: 301 W FRANKLIN
    TAYLORVILLE, IL
    ZIP 62568
  • Facility Phone: 217 824-4961
  • Facility Type: Other - JAIL
  • Facility Type: Waiver
  • Lab Director: BRUCE KETTELKAMP
  • NPI Number: 1508526864
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 14D2143643
LAB Type Other - JAIL
Facility Name CHRISTIAN COUNTY SHERIFF
Street 301 W FRANKLIN
City TAYLORVILLE
State IL
ZIP 62568
Phone 217 824-4961
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/2/2024
Certificate Expiration Date 2/1/2026
Facility Type Other - JAIL
Lab Director BRUCE KETTELKAMP

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