14D2236329 CLIA NUMBER - CHRISTOPHER CUSD #99

Laboratory Demographics

CLIA Number: 14D2236329

Facility Name: CHRISTOPHER CUSD #99

Facility Address:
501 S SNIDER ST
CHRISTOPHER, IL
ZIP 62822
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Facility Phone Number: 618 724-2631

Facility Type: School/Student Health Service

Certificate Type: Waiver

NPI Number: 1285241877

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D2236329
LAB Type	School/Student Health Service
Facility Name	CHRISTOPHER CUSD #99
Street	501 S SNIDER ST
City	CHRISTOPHER
State	IL
ZIP	62822
Phone	618 724-2631
CertificateType	4
CertificateEffectiveDate	9/16/2023
CertificateExpirationDate	9/15/2025
FacilityType	Waiver

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