14D2161405 CLIA NUMBER - MADISON COUNTY SHERIFF'S OFFICE (JAIL DIVISION)

Laboratory Demographics

  • CLIA Code: 14D2161405
  • Facility Name: MADISON COUNTY SHERIFF'S OFFICE (JAIL DIVISION)
  • Facility Address: 405 RANDLE
    EDWARDSVILLE, IL
    ZIP 62025
  • Facility Phone: 618 296-4833
  • Facility Type: Other - JAIL
  • Facility Type: Waiver
  • Lab Director: KRISTOPHER M. THARP
  • NPI Number: 1093430266
  • Taxonomy: 237700000X - Hearing Instrument Specialist

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CLIA Record

Field Name Field Value
CLIA Number 14D2161405
LAB Type Other - JAIL
Facility Name MADISON COUNTY SHERIFF'S OFFICE (JAIL DIVISION)
Street 405 RANDLE
City EDWARDSVILLE
State IL
ZIP 62025
Phone 618 296-4833
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/1/2025
Certificate Expiration Date 1/31/2027
Facility Type Other - JAIL
Lab Director KRISTOPHER M. THARP

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