14D2121091 CLIA NUMBER - LUTHER OAKS

Laboratory Demographics

  • CLIA Code: 14D2121091
  • Facility Name: LUTHER OAKS
  • Facility Address: 601 LUTZ RD
    BLOOMINGTON, IL
    ZIP 61704
  • Facility Phone: 309 557-8000
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: TIMOTHY L. KMETZ
  • NPI Number: 1639520034
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 14D2121091
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name LUTHER OAKS
Street 601 LUTZ RD
City BLOOMINGTON
State IL
ZIP 61704
Phone 309 557-8000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/31/2024
Certificate Expiration Date 10/30/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director TIMOTHY L. KMETZ

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