14D2146245 CLIA NUMBER - SPARTA TERRACE

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CLIA Record

Field Name Field Value
CLIA Number 14D2146245
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name SPARTA TERRACE
Street 1501 MELMAR DR
City SPARTA
State IL
ZIP 62286
Phone 217 287-7787
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/26/2024
Certificate Expiration Date 3/25/2026
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director KARLA ROGERS

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