14D1013189 CLIA NUMBER - RENAL INTERVENTION CENTER

Laboratory Demographics

  • CLIA Code: 14D1013189
  • Facility Name: RENAL INTERVENTION CENTER
  • Facility Address: 430 W MAXINE DR
    MORTON, IL
    ZIP 61550
  • Facility Phone: (309) 266-7600
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: SAMER B. SADER
  • NPI Number: 1639242506
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D1013189
LAB Type Ambulatory Surgery Center
Facility Name RENAL INTERVENTION CENTER
Street 430 W MAXINE DR
City MORTON
State IL
ZIP 61550
Phone 3092667600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/3/2025
Certificate Expiration Date 6/2/2027
Facility Type Ambulatory Surgery Center
Lab Director SAMER B. SADER

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This page was last updated on: 5/18/2026