14D0429775 CLIA NUMBER - POLO REHABILITATION & HEALTH CARE CENTER

Laboratory Demographics

  • CLIA Code: 14D0429775
  • Facility Name: POLO REHABILITATION & HEALTH CARE CENTER
  • Facility Address: 703 E BUFFALO
    POLO, IL
    ZIP 61064
  • Facility Phone: 815 946-2203
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: KERRY A. THOMASON
  • NPI Number: 1295732360
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 14D0429775
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name POLO REHABILITATION & HEALTH CARE CENTER
Street 703 E BUFFALO
City POLO
State IL
ZIP 61064
Phone 815 946-2203
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director KERRY A. THOMASON

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