14D2166211 CLIA NUMBER - ACTIVE DAY OF MARION

Laboratory Demographics

  • CLIA Code: 14D2166211
  • Facility Name: ACTIVE DAY OF MARION
  • Facility Address: 900 SKYLINE DR #301
    MARION, IL
    ZIP 62959
  • Facility Phone: 215 642-6269
  • Facility Type: Other - ADULT DAY CARE
  • Facility Type: Waiver
  • Lab Director: VANESSA L. FORTMAN
  • NPI Number: 1326583253
  • Taxonomy: 261QA0600X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2166211
LAB Type Other - ADULT DAY CARE
Facility Name ACTIVE DAY OF MARION
Street 900 SKYLINE DR #301
City MARION
State IL
ZIP 62959
Phone 215 642-6269
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/14/2025
Certificate Expiration Date 5/13/2027
Facility Type Other - ADULT DAY CARE
Lab Director VANESSA L. FORTMAN

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