14D0951924 CLIA NUMBER - MERCY RICHMOND MEDICAL CENTER

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Laboratory Demographics

CLIA Number: 14D0951924

Facility Name: MERCY RICHMOND MEDICAL CENTER

Facility Address:
9715 PRAIRIE RIDGE
RICHMOND, IL
ZIP 60071
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Facility Phone Number: 815 678-4528

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1417073396

Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

CLIA Record

Field Name	Field Value
CLIA Number	14D0951924
LAB Type	Community Clinic
Facility Name	MERCY RICHMOND MEDICAL CENTER
Street	9715 PRAIRIE RIDGE
City	RICHMOND
State	IL
ZIP	60071
Phone	815 678-4528
CertificateType	4
CertificateEffectiveDate	9/30/2022
CertificateExpirationDate	9/29/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024