14D2182421 CLIA NUMBER - BROOKSTONE ESTATES OF FAIRFIELD

Laboratory Demographics

  • CLIA Code: 14D2182421
  • Facility Name: BROOKSTONE ESTATES OF FAIRFIELD
  • Facility Address: 315 N MARKET AVE
    FAIRFIELD, IL
    ZIP 62837
  • Facility Phone: (618) 842-5875
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: DIANA KELLY
  • NPI Number: 1619365962
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 14D2182421
LAB Type Assisted Living Facility
Facility Name BROOKSTONE ESTATES OF FAIRFIELD
Street 315 N MARKET AVE
City FAIRFIELD
State IL
ZIP 62837
Phone 6188425875
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/29/2025
Certificate Expiration Date 12/28/2027
Facility Type Assisted Living Facility
Lab Director DIANA KELLY

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This page was last updated on: 5/18/2026