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14D2210072 CLIA NUMBER - CHANNAHON SCHOOL DISTRICT 17

Laboratory Demographics

CLIA Number: 14D2210072

Facility Name: CHANNAHON SCHOOL DISTRICT 17

Facility Address:
24920 S SAGE ST
CHANNAHON, IL
ZIP 60410
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Facility Phone Number: 815 467-4315

Facility Type: School/Student Health Service

Certificate Type: Waiver
NPI Number: 1437328853

Taxonomy: 251300000X - Local Education Agency (LEA)
The term local education agency means a public board of education or other public authority legally constituted within a State to either provide administrative control or direction of, or perform a service function for public schools serving individuals ages 0 - 21 in a state, city, county, township, school district, or other political subdivision including a combination of school districts or counties recognized in a State as an administrative agency for its public schools. An LEA may provide, or employ professional who provide, services to children included in the Individuals with Disabilities Education Act (IDEA), such services may include, but are not limited to, such medical services as physical, occupational, and speech therapy.

CLIA Record

Field Name Field Value
CLIA Number 14D2210072
LAB Type School/Student Health Service
Facility Name CHANNAHON SCHOOL DISTRICT 17
Street 24920 S SAGE ST
City CHANNAHON
State IL
ZIP 60410
Phone 815 467-4315
CertificateType 4
CertificateEffectiveDate 1/19/2023
CertificateExpirationDate 1/18/2025
FacilityType Waiver

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