14D2197355 CLIA NUMBER - CAMBRIDGE HOUSE OF O'FALLON

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Laboratory Demographics

CLIA Number: 14D2197355

Facility Name: CAMBRIDGE HOUSE OF O'FALLON

Facility Address:
844 CAMBRIDGE BLVD
O FALLON, IL
ZIP 62269
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Facility Phone Number: 618 206-4103

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1932304789

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	14D2197355
LAB Type	Assisted Living Facility
Facility Name	CAMBRIDGE HOUSE OF O'FALLON
Street	844 CAMBRIDGE BLVD
City	O FALLON
State	IL
ZIP	62269
Phone	618 206-4103
CertificateType	4
CertificateEffectiveDate	10/23/2022
CertificateExpirationDate	10/22/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024