14D2235464 CLIA NUMBER - AVONLEA COTTAGE UNITED RESOURCE MANAGEMENT LLC

Laboratory Demographics

CLIA Number: 14D2235464

Facility Name: AVONLEA COTTAGE UNITED RESOURCE MANAGEMENT LLC

Facility Address:
2025 E 1ST ST
MILAN, IL
ZIP 61264
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Facility Phone Number: 309 756-2257

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1306005863

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	14D2235464
LAB Type	Assisted Living Facility
Facility Name	AVONLEA COTTAGE UNITED RESOURCE MANAGEMENT LLC
Street	2025 E 1ST ST
City	MILAN
State	IL
ZIP	61264
Phone	309 756-2257
CertificateType	4
CertificateEffectiveDate	9/9/2023
CertificateExpirationDate	9/8/2025
FacilityType	Waiver

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