14D0920985 CLIA NUMBER - MOUNT ST JOSEPH I C F - D D

Laboratory Demographics

  • CLIA Code: 14D0920985
  • Facility Name: MOUNT ST JOSEPH I C F - D D
  • Facility Address: 24955 NORTH U S HIGHWAY 12
    LAKE ZURICH, IL
    ZIP 60047
  • Facility Phone: 847 438-5050
  • Facility Type: Intermediate Care Facility for Mentally Retarded
  • Facility Type: Waiver
  • Lab Director: SISTER JANET KOSMAN
  • NPI Number: 1033219803
  • Taxonomy: 315P00000X - Intermediate Care Facility, Intellectual Disabilities

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CLIA Record

Field Name Field Value
CLIA Number 14D0920985
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name MOUNT ST JOSEPH I C F - D D
Street 24955 NORTH U S HIGHWAY 12
City LAKE ZURICH
State IL
ZIP 60047
Phone 847 438-5050
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/16/2024
Certificate Expiration Date 10/15/2026
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director SISTER JANET KOSMAN

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