14D0969552 CLIA NUMBER - KANKAKEE COMMUNITY HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 14D0969552
  • Facility Name: KANKAKEE COMMUNITY HEALTH CENTER
  • Facility Address: 1777 E COURT ST
    KANKAKEE, IL
    ZIP 60901
  • Facility Phone: 708 747-7677
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: SMITHA SAMUEL M D
  • NPI Number: 1841829454
  • Taxonomy: 207P00000X - Emergency Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D0969552
LAB Type Federally Qualified Health Center
Facility Name KANKAKEE COMMUNITY HEALTH CENTER
Street 1777 E COURT ST
City KANKAKEE
State IL
ZIP 60901
Phone 708 747-7677
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 1/19/2024
Certificate Expiration Date 1/18/2026
Facility Type Federally Qualified Health Center
Lab Director SMITHA SAMUEL M D

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