14D2107481 CLIA NUMBER - OSF HEALTHCARE - MEDICAL GROUP - ROCK CUT

Laboratory Demographics

  • CLIA Code: 14D2107481
  • Facility Name: OSF HEALTHCARE - MEDICAL GROUP - ROCK CUT
  • Facility Address: 9951 ROCK CUT CROSSING
    LOVES PARK, IL
    ZIP 61111
  • Facility Phone: 815 639-8582
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: MICHAEL KOUIMELIS
  • NPI Number: 1508567298
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2107481
LAB Type Rural Health Clinic
Facility Name OSF HEALTHCARE - MEDICAL GROUP - ROCK CUT
Street 9951 ROCK CUT CROSSING
City LOVES PARK
State IL
ZIP 61111
Phone 815 639-8582
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/14/2024
Certificate Expiration Date 1/13/2026
Facility Type Rural Health Clinic
Lab Director MICHAEL KOUIMELIS

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