14D0674703 CLIA NUMBER - SOUTH HOLLAND MANOR HEALTH & REHAB

Laboratory Demographics

  • CLIA Code: 14D0674703
  • Facility Name: SOUTH HOLLAND MANOR HEALTH & REHAB
  • Facility Address: 2145 E 170TH ST
    SOUTH HOLLAND, IL
    ZIP 60473
  • Facility Phone: 708 895-3255
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ANDREA FRENCHER
  • NPI Number: 1922575752
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 14D0674703
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name SOUTH HOLLAND MANOR HEALTH & REHAB
Street 2145 E 170TH ST
City SOUTH HOLLAND
State IL
ZIP 60473
Phone 708 895-3255
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 ANDREA FRENCHER

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