14D2213433 CLIA NUMBER - CHARLESTON CUSD#1

Laboratory Demographics

CLIA Number: 14D2213433

Facility Name: CHARLESTON CUSD#1

Facility Address:
1615 LINCOLN AVE
CHARLESTON, IL
ZIP 61920
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Facility Phone Number: 217 639-5015

Facility Type: School/Student Health Service

Certificate Type: Waiver

NPI Number: 1609972165

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	14D2213433
LAB Type	School/Student Health Service
Facility Name	CHARLESTON CUSD#1
Street	1615 LINCOLN AVE
City	CHARLESTON
State	IL
ZIP	61920
Phone	217 639-5015
CertificateType	4
CertificateEffectiveDate	2/12/2023
CertificateExpirationDate	2/11/2025
FacilityType	Waiver

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