CLIA lab
CLIA 14D2164020: Moultrie Co Detention Center
Sullivan, IL. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 14D2164020 belongs to Moultrie Co Detention Center in Sullivan, IL.
Certificate of Waiver, effective March 26, 2025, expires March 25, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Run it in Rivvi
Map your lab's test names to LOINC codes
Open in RivviFree to start. Opens Rivvi, the AI workspace for healthcare teams.
Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- March 26, 2025
- Certificate expiration
- March 25, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- March 26, 2019
- Facility type
- Other
- Ownership (control type)
- Government, county
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 14D2164020
- Lab name
- Moultrie Co Detention Center
- Address
- 1505 W Hagerman Rd, Sullivan, IL 61951
- Phone
- (217) 728-4386
- Fax
- (217) 728-4859
Annual test volume the lab reported
- Waived tests
- 100
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Sullivan, IL
- C V S / Pharmacy #6923Certificate of Waiver, Pharmacy14D2283719
- Community Homecare IncCertificate of Waiver, Home health agency14D1023194
- Memorial Care in SullivanCertificate of Waiver, Physician office14D1045949
- Moultrie County Health DepartmentCertificate of Waiver, Other14D0973071
- Oakwood ApothecaryCertificate of Waiver, Pharmacy14D2260915
- Sullivan Family Care CenterCertificate for Provider-Performed Microscopy Procedures, Physician office14D0872015
Related
Questions
What is the CLIA number for Moultrie Co Detention Center in Sullivan?
14D2164020, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Moultrie Co Detention Center hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 14D2164020 expire?
The CMS file lists March 25, 2027 as the certificate expiration date; the certificate took effect March 26, 2025.