14D2095092 CLIA NUMBER - ROCKFORD HEALTH PHYSICIANS - BELVIDERE

Laboratory Demographics

  • CLIA Code: 14D2095092
  • Facility Name: ROCKFORD HEALTH PHYSICIANS - BELVIDERE
  • Facility Address: 1747 HENRY LUCKOW LANE
    BELVIDERE, IL
    ZIP 61008
  • Facility Phone: 815 971-4762
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KENT A. NICKELL
  • NPI Number: 1538512462
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 14D2095092
LAB Type Physician Office
Facility Name ROCKFORD HEALTH PHYSICIANS - BELVIDERE
Street 1747 HENRY LUCKOW LANE
City BELVIDERE
State IL
ZIP 61008
Phone 815 971-4762
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/5/2024
Certificate Expiration Date 11/4/2026
Facility Type Physician Office
Lab Director KENT A. NICKELL

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