14D2016902 CLIA NUMBER - STONECREST DIALYSIS

Laboratory Demographics

  • CLIA Code: 14D2016902
  • Facility Name: STONECREST DIALYSIS
  • Facility Address: 1302 E STATE ST
    ROCKFORD, IL
    ZIP 61104
  • Facility Phone: 815 968-5794
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: JOANNA NIEMIEC MD
  • NPI Number: 1518276955
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2016902
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name STONECREST DIALYSIS
Street 1302 E STATE ST
City ROCKFORD
State IL
ZIP 61104
Phone 815 968-5794
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/30/2024
Certificate Expiration Date 11/29/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director JOANNA NIEMIEC MD

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