14D2199445 CLIA NUMBER - SUPPORTIVE LIVING OF WASHINGTON

Laboratory Demographics

  • CLIA Code: 14D2199445
  • Facility Name: SUPPORTIVE LIVING OF WASHINGTON
  • Facility Address: 1150 NEWCASTLE RD
    WASHINGTON, IL
    ZIP 61571
  • Facility Phone: 309 412-6139
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: AMY L. ITSCHNER
  • NPI Number: 1265616536
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 14D2199445
LAB Type Assisted Living Facility
Facility Name SUPPORTIVE LIVING OF WASHINGTON
Street 1150 NEWCASTLE RD
City WASHINGTON
State IL
ZIP 61571
Phone 309 412-6139
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/9/2024
Certificate Expiration Date 11/8/2026
Facility Type Assisted Living Facility
Lab Director AMY L. ITSCHNER

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