14D2149079 CLIA NUMBER - OSF ON CALL URGENT CARE -PEORIA KNOXVILLE CROSSING

Laboratory Demographics

  • CLIA Code: 14D2149079
  • Facility Name: OSF ON CALL URGENT CARE -PEORIA KNOXVILLE CROSSING
  • Facility Address: 10408 N CENTERWAY DR - STE C, D & E
    PEORIA, IL
    ZIP 61615
  • Facility Phone: 309 683-7253
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MELINDA B. COOLING
  • NPI Number: 1982170734
  • Taxonomy: 332900000X - Non-Pharmacy Dispensing Site

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CLIA Record

Field Name Field Value
CLIA Number 14D2149079
LAB Type Physician Office
Facility Name OSF ON CALL URGENT CARE -PEORIA KNOXVILLE CROSSING
Street 10408 N CENTERWAY DR - STE C, D & E
City PEORIA
State IL
ZIP 61615
Phone 309 683-7253
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/24/2024
Certificate Expiration Date 5/23/2026
Facility Type Physician Office
Lab Director MELINDA B. COOLING

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This page was last updated on: 6/4/2025