14D0433748 CLIA NUMBER - NOKOMIS REHAB & HEALTH CARE CENTER (D/B/A) PETERSON HEALTH NETWORK LLC

Laboratory Demographics

  • CLIA Code: 14D0433748
  • Facility Name: NOKOMIS REHAB & HEALTH CARE CENTER (D/B/A) PETERSON HEALTH NETWORK LLC
  • Facility Address: 505 STEVENS ST
    NOKOMIS, IL
    ZIP 62075
  • Facility Phone: 217 563-7725
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: TAMMI J. ANDRIES
  • NPI Number: 1952399255
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 14D0433748
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name NOKOMIS REHAB & HEALTH CARE CENTER (D/B/A) PETERSON HEALTH NETWORK LLC
Street 505 STEVENS ST
City NOKOMIS
State IL
ZIP 62075
Phone 217 563-7725
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 TAMMI J. ANDRIES

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