14D2187374 CLIA NUMBER - TWO ROADS WELLNESS CLINIC

Laboratory Demographics

  • CLIA Code: 14D2187374
  • Facility Name: TWO ROADS WELLNESS CLINIC
  • Facility Address: 3545 N VERMILION
    DANVILLE, IL
    ZIP 61832
  • Facility Phone: 217 651-6801
  • Facility Type: Other - APRNS
  • Facility Type: Waiver
  • Lab Director: SASHA M. POWELL
  • NPI Number: 1417329426
  • Taxonomy: 363LP2300X - Nurse Practitioner

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D2187374
LAB Type Other - APRNS
Facility Name TWO ROADS WELLNESS CLINIC
Street 3545 N VERMILION
City DANVILLE
State IL
ZIP 61832
Phone 217 651-6801
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/4/2025
Certificate Expiration Date 5/3/2027
Facility Type Other - APRNS
Lab Director SASHA M. POWELL

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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