14D2190252 CLIA NUMBER - KING-BRUWAERT HOUSE

Laboratory Demographics

  • CLIA Code: 14D2190252
  • Facility Name: KING-BRUWAERT HOUSE
  • Facility Address: 6101 S COUNTY LINE RD
    BURR RIDGE, IL
    ZIP 60527
  • Facility Phone: 630 323-2250
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: RAHMAWATI SIH M D
  • NPI Number: 1376960039
  • Taxonomy: 314000000X - Skilled Nursing Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D2190252
LAB Type Assisted Living Facility
Facility Name KING-BRUWAERT HOUSE
Street 6101 S COUNTY LINE RD
City BURR RIDGE
State IL
ZIP 60527
Phone 630 323-2250
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/11/2024
Certificate Expiration Date 8/10/2026
Facility Type Assisted Living Facility
Lab Director RAHMAWATI SIH M D

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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