14D2099502 CLIA NUMBER - RIVERSIDE WOMEN'S HEALTH KANKAKEE

Laboratory Demographics

  • CLIA Code: 14D2099502
  • Facility Name: RIVERSIDE WOMEN'S HEALTH KANKAKEE
  • Facility Address: 375 N WALL ST, SUITE 610
    KANKAKEE, IL
    ZIP 60901
  • Facility Phone: 815 935-4651
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LIZY ANDREWS
  • NPI Number: 1417056532
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2099502
LAB Type Physician Office
Facility Name RIVERSIDE WOMEN'S HEALTH KANKAKEE
Street 375 N WALL ST, SUITE 610
City KANKAKEE
State IL
ZIP 60901
Phone 815 935-4651
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/27/2025
Certificate Expiration Date 3/26/2027
Facility Type Physician Office
Lab Director LIZY ANDREWS

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