14D2133501 CLIA NUMBER - CRUSADER COMMUNITY HEALTH SOUTH BELOIT HS

Laboratory Demographics

  • CLIA Code: 14D2133501
  • Facility Name: CRUSADER COMMUNITY HEALTH SOUTH BELOIT HS
  • Facility Address: 245 PRAIRIE HILL ROAD
    SOUTH BELOIT, IL
    ZIP 61080
  • Facility Phone: 815 490-1600
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: AMANDA FLORES
  • NPI Number: 1265601488
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2133501
LAB Type Federally Qualified Health Center
Facility Name CRUSADER COMMUNITY HEALTH SOUTH BELOIT HS
Street 245 PRAIRIE HILL ROAD
City SOUTH BELOIT
State IL
ZIP 61080
Phone 815 490-1600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/13/2025
Certificate Expiration Date 7/12/2027
Facility Type Federally Qualified Health Center
Lab Director AMANDA FLORES

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