14D2212272 CLIA NUMBER - PORTA C U S D 202

Laboratory Demographics

  • CLIA Code: 14D2212272
  • Facility Name: PORTA C U S D 202
  • Facility Address: 17651 BLUEJAY RD
    PETERSBURG, IL
    ZIP 62675
  • Facility Phone: 217 632-3216
  • Facility Type: School/Student Health Service
  • Facility Type: Waiver
  • Lab Director: BRIANNA TODD
  • NPI Number: 1962519405
  • Taxonomy: 251300000X - Local Education Agency (LEA)

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CLIA Record

Field Name Field Value
CLIA Number 14D2212272
LAB Type School/Student Health Service
Facility Name PORTA C U S D 202
Street 17651 BLUEJAY RD
City PETERSBURG
State IL
ZIP 62675
Phone 217 632-3216
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/3/2025
Certificate Expiration Date 2/2/2027
Facility Type School/Student Health Service
Lab Director BRIANNA TODD

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