14D2192544 CLIA NUMBER - COURTYARD ESTATES OF KEWANEE

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Laboratory Demographics

CLIA Number: 14D2192544

Facility Name: COURTYARD ESTATES OF KEWANEE

Facility Address:
141 JUNIOR AVE
KEWANEE, IL
ZIP 61443
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Facility Phone Number: 309 853-2460

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1215061346

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	14D2192544
LAB Type	Assisted Living Facility
Facility Name	COURTYARD ESTATES OF KEWANEE
Street	141 JUNIOR AVE
City	KEWANEE
State	IL
ZIP	61443
Phone	309 853-2460
CertificateType	4
CertificateEffectiveDate	9/11/2022
CertificateExpirationDate	9/10/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024