14D1037539 CLIA NUMBER - TIMBERCREEK REHABILITATION & HEALTH CARE CENTER PETERSEN HEALTH OPERATIONS LLC

Laboratory Demographics

  • CLIA Code: 14D1037539
  • Facility Name: TIMBERCREEK REHABILITATION & HEALTH CARE CENTER PETERSEN HEALTH OPERATIONS LLC
  • Facility Address: 2220 STATE STREET
    PEKIN, IL
    ZIP 61554
  • Facility Phone: 309 347-1110
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ALYSSA D. BAUER
  • NPI Number: 1346340569
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 14D1037539
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name TIMBERCREEK REHABILITATION & HEALTH CARE CENTER PETERSEN HEALTH OPERATIONS LLC
Street 2220 STATE STREET
City PEKIN
State IL
ZIP 61554
Phone 309 347-1110
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/28/2025
Certificate Expiration Date 2/27/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director ALYSSA D. BAUER

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This page was last updated on: 6/4/2025