14D2143967 CLIA NUMBER - MENARD COUNTY JAIL

Laboratory Demographics

  • CLIA Code: 14D2143967
  • Facility Name: MENARD COUNTY JAIL
  • Facility Address: 315 S 6TH
    PETERSBURG, IL
    ZIP 62675
  • Facility Phone: 217 632-2273
  • Facility Type: Other - JAIL
  • Facility Type: Waiver
  • Lab Director: MARK OLLER
  • NPI Number: 1982633541
  • Taxonomy: 341600000X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 14D2143967
LAB Type Other - JAIL
Facility Name MENARD COUNTY JAIL
Street 315 S 6TH
City PETERSBURG
State IL
ZIP 62675
Phone 217 632-2273
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/8/2024
Certificate Expiration Date 2/7/2026
Facility Type Other - JAIL
Lab Director MARK OLLER

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