14D0725286 CLIA NUMBER - PAVILION ON MAIN

Laboratory Demographics

  • CLIA Code: 14D0725286
  • Facility Name: PAVILION ON MAIN
  • Facility Address: 515 N MAIN
    SANDWICH, IL
    ZIP 60548
  • Facility Phone: 815 786-8426
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: MICHELE SCHMIDT
  • NPI Number: 1780661165
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 14D0725286
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PAVILION ON MAIN
Street 515 N MAIN
City SANDWICH
State IL
ZIP 60548
Phone 815 786-8426
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 MICHELE SCHMIDT

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