14D2103552 CLIA NUMBER - RIVERSIDE CANCER TREATMENT CENTER

Laboratory Demographics

  • CLIA Code: 14D2103552
  • Facility Name: RIVERSIDE CANCER TREATMENT CENTER
  • Facility Address: 200 RIVERSIDE DR
    BOURBONNAIS, IL
    ZIP 60914
  • Facility Phone: 815 935-7535
  • Facility Type: Other - CANCER TRMT CTR
  • Facility Type: Accreditation
  • Lab Director: NOMAN SIDDIQUI
  • NPI Number: 1265716450
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 14D2103552
LAB Type Other - CANCER TRMT CTR
Facility Name RIVERSIDE CANCER TREATMENT CENTER
Street 200 RIVERSIDE DR
City BOURBONNAIS
State IL
ZIP 60914
Phone 815 935-7535
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 1/11/2025
Certificate Expiration Date 1/10/2027
Facility Type Other - CANCER TRMT CTR
Lab Director NOMAN SIDDIQUI

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