14D0857949 CLIA NUMBER - SIMON WU MD LTD

Laboratory Demographics

  • CLIA Code: 14D0857949
  • Facility Name: SIMON WU MD LTD
  • Facility Address: 401 N WALL ST STE 303
    KANKAKEE, IL
    ZIP 60901
  • Facility Phone: 815 933-1664
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SIMON K. WU
  • NPI Number: 1407044241
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D0857949
LAB Type Physician Office
Facility Name SIMON WU MD LTD
Street 401 N WALL ST STE 303
City KANKAKEE
State IL
ZIP 60901
Phone 815 933-1664
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/18/2024
Certificate Expiration Date 6/17/2026
Facility Type Physician Office
Lab Director SIMON K. WU

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