14D0858549 CLIA NUMBER - BLOOMINGTON REHABILITATION & HEALTH CARE CENTER PETERSEN HEALTH OPERATIONS LLC

Laboratory Demographics

  • CLIA Code: 14D0858549
  • Facility Name: BLOOMINGTON REHABILITATION & HEALTH CARE CENTER PETERSEN HEALTH OPERATIONS LLC
  • Facility Address: 1925 S MAIN ST
    BLOOMINGTON, IL
    ZIP 61704
  • Facility Phone: 309 829-4348
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: KATHRYN R. KNOTT
  • NPI Number: 1407008683
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 14D0858549
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name BLOOMINGTON REHABILITATION & HEALTH CARE CENTER PETERSEN HEALTH OPERATIONS LLC
Street 1925 S MAIN ST
City BLOOMINGTON
State IL
ZIP 61704
Phone 309 829-4348
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 KATHRYN R. KNOTT

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