14D0681827 CLIA NUMBER - HERITAGE MANOR PERU L L C

Laboratory Demographics

  • CLIA Code: 14D0681827
  • Facility Name: HERITAGE MANOR PERU L L C
  • Facility Address: 1301 21ST STREET
    PERU, IL
    ZIP 61354
  • Facility Phone: 815 223-4901
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ALLISON CIESIELSKI
  • NPI Number: 1164766861
  • Taxonomy: 332BX2000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 14D0681827
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name HERITAGE MANOR PERU L L C
Street 1301 21ST STREET
City PERU
State IL
ZIP 61354
Phone 815 223-4901
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 ALLISON CIESIELSKI

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