14D0700691 CLIA NUMBER - WESLEY VILLAGE HEALTH CARE CENTER

Laboratory Demographics

  • CLIA Code: 14D0700691
  • Facility Name: WESLEY VILLAGE HEALTH CARE CENTER
  • Facility Address: 1200 E GRANT ST
    MACOMB, IL
    ZIP 61455
  • Facility Phone: 309 833-2123
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: FRANK LASALA
  • NPI Number: 1558471714
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 14D0700691
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name WESLEY VILLAGE HEALTH CARE CENTER
Street 1200 E GRANT ST
City MACOMB
State IL
ZIP 61455
Phone 309 833-2123
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 FRANK LASALA

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