14D0716578 CLIA NUMBER - OSF HEALTHCARE CHILDREN'S HOSP OF IL PEDS DIABETES

Laboratory Demographics

  • CLIA Code: 14D0716578
  • Facility Name: OSF HEALTHCARE CHILDREN'S HOSP OF IL PEDS DIABETES
  • Facility Address: 530 NE GLEN OAK AVE - STE 1141
    PEORIA, IL
    ZIP 61637
  • Facility Phone: 309 624-2480
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: ASHLEY R. CHITWOOD
  • NPI Number: 1295370039
  • Taxonomy: 273R00000X - Psychiatric Unit

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CLIA Record

Field Name Field Value
CLIA Number 14D0716578
LAB Type Ancillary Testing Site in Health Care Center
Facility Name OSF HEALTHCARE CHILDREN'S HOSP OF IL PEDS DIABETES
Street 530 NE GLEN OAK AVE - STE 1141
City PEORIA
State IL
ZIP 61637
Phone 309 624-2480
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/7/2024
Certificate Expiration Date 1/6/2026
Facility Type Ancillary Testing Site in Health Care Center
Lab Director ASHLEY R. CHITWOOD

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