14D2058344 CLIA NUMBER - TAZEWELL COUNTY DIALYSIS (DBA) PEKIN DIALYSIS L L C

Laboratory Demographics

  • CLIA Code: 14D2058344
  • Facility Name: TAZEWELL COUNTY DIALYSIS (DBA) PEKIN DIALYSIS L L C
  • Facility Address: 1021 COURT ST
    PEKIN, IL
    ZIP 61554
  • Facility Phone: 309 478-1000
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: ASHAN USMAN
  • NPI Number: 1619218732
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2058344
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name TAZEWELL COUNTY DIALYSIS (DBA) PEKIN DIALYSIS L L C
Street 1021 COURT ST
City PEKIN
State IL
ZIP 61554
Phone 309 478-1000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/6/2025
Certificate Expiration Date 5/5/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director ASHAN USMAN

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