14D2194854 CLIA NUMBER - EVERGREEN PLACE

Laboratory Demographics

  • CLIA Code: 14D2194854
  • Facility Name: EVERGREEN PLACE
  • Facility Address: 1015 TYLER AVE
    LITCHFIELD, IL
    ZIP 62056
  • Facility Phone: 217 324-1550
  • Facility Type: Other - SUPPORTIVE LIVING FAC
  • Facility Type: Waiver
  • Lab Director: AMY WILLIAMS
  • NPI Number: 1376798777
  • Taxonomy: 310400000X - Assisted Living Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D2194854
LAB Type Other - SUPPORTIVE LIVING FAC
Facility Name EVERGREEN PLACE
Street 1015 TYLER AVE
City LITCHFIELD
State IL
ZIP 62056
Phone 217 324-1550
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/5/2024
Certificate Expiration Date 10/4/2026
Facility Type Other - SUPPORTIVE LIVING FAC
Lab Director AMY WILLIAMS

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