14D2156706 CLIA NUMBER - GREAT HEIGHTS MEDICAL L T D

Laboratory Demographics

  • CLIA Code: 14D2156706
  • Facility Name: GREAT HEIGHTS MEDICAL L T D
  • Facility Address: 315 E MCKINLEY RD
    OTTAWA, IL
    ZIP 61350
  • Facility Phone: 815 434-0228
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ADEYEMI O. FATOKI M D
  • NPI Number: 1609303940
  • Taxonomy: 2083A0300X - Preventive Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2156706
LAB Type Physician Office
Facility Name GREAT HEIGHTS MEDICAL L T D
Street 315 E MCKINLEY RD
City OTTAWA
State IL
ZIP 61350
Phone 815 434-0228
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/23/2024
Certificate Expiration Date 10/22/2026
Facility Type Physician Office
Lab Director ADEYEMI O. FATOKI M D

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