14D2195527 CLIA NUMBER - BROOKSTONE ESTATES OF MATTOON NORTH

Laboratory Demographics

  • CLIA Code: 14D2195527
  • Facility Name: BROOKSTONE ESTATES OF MATTOON NORTH
  • Facility Address: 1920 BROOKSTONE LANE
    MATTOON, IL
    ZIP 61938
  • Facility Phone: 217 235-5881
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: ERICA OZIER
  • NPI Number: 1265820526
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 14D2195527
LAB Type Assisted Living Facility
Facility Name BROOKSTONE ESTATES OF MATTOON NORTH
Street 1920 BROOKSTONE LANE
City MATTOON
State IL
ZIP 61938
Phone 217 235-5881
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/9/2024
Certificate Expiration Date 10/8/2026
Facility Type Assisted Living Facility
Lab Director ERICA OZIER

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