14D2118043 CLIA NUMBER - ROCKFORD HEALTH MEDICAL LAB-CHERRY VALLEY

Laboratory Demographics

  • CLIA Code: 14D2118043
  • Facility Name: ROCKFORD HEALTH MEDICAL LAB-CHERRY VALLEY
  • Facility Address: 6998 REDANSA DR
    ROCKFORD, IL
    ZIP 61108
  • Facility Phone: (815) 971-4762
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KENT A. NICKELL
  • NPI Number: 1881702488
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 14D2118043
LAB Type Physician Office
Facility Name ROCKFORD HEALTH MEDICAL LAB-CHERRY VALLEY
Street 6998 REDANSA DR
City ROCKFORD
State IL
ZIP 61108
Phone 8159714762
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/29/2024
Certificate Expiration Date 8/28/2026
Facility Type Physician Office
Lab Director KENT A. NICKELL

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This page was last updated on: 6/29/2026