14D2201652 CLIA NUMBER - SWANN SPECIAL CARE CENTER

Laboratory Demographics

  • CLIA Code: 14D2201652
  • Facility Name: SWANN SPECIAL CARE CENTER
  • Facility Address: 109 KENWOOD RD
    CHAMPAIGN, IL
    ZIP 61821
  • Facility Phone: 217 356-5164
  • Facility Type: Intermediate Care Facility for Mentally Retarded
  • Facility Type: Waiver
  • Lab Director: KYM HALBERSTADT
  • NPI Number: 1992838916
  • Taxonomy: 3140N1450X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 14D2201652
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name SWANN SPECIAL CARE CENTER
Street 109 KENWOOD RD
City CHAMPAIGN
State IL
ZIP 61821
Phone 217 356-5164
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/23/2024
Certificate Expiration Date 11/22/2026
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director KYM HALBERSTADT

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