14D0857960 CLIA NUMBER - OSF HEALTHCARE- MEDICAL GROUP - DWIGHT

Laboratory Demographics

  • CLIA Code: 14D0857960
  • Facility Name: OSF HEALTHCARE- MEDICAL GROUP - DWIGHT
  • Facility Address: 107 WATTERS DR
    DWIGHT, IL
    ZIP 60420
  • Facility Phone: 815 584-3343
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: MAULIN SHAH
  • NPI Number: 1205551652
  • Taxonomy: 261QR1300X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D0857960
LAB Type Rural Health Clinic
Facility Name OSF HEALTHCARE- MEDICAL GROUP - DWIGHT
Street 107 WATTERS DR
City DWIGHT
State IL
ZIP 60420
Phone 815 584-3343
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/7/2025
Certificate Expiration Date 1/6/2027
Facility Type Rural Health Clinic
Lab Director MAULIN SHAH

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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