14D2194555 CLIA NUMBER - LOCAL N P

Laboratory Demographics

  • CLIA Code: 14D2194555
  • Facility Name: LOCAL N P
  • Facility Address: 917 1ST ST
    LA SALLE, IL
    ZIP 61301
  • Facility Phone: 815 780-2525
  • Facility Type: Other - APRN CLINIC OFFICE
  • Facility Type: Waiver
  • Lab Director: JENNIFER L. OLESEN
  • NPI Number: 1992317523
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 14D2194555
LAB Type Other - APRN CLINIC OFFICE
Facility Name LOCAL N P
Street 917 1ST ST
City LA SALLE
State IL
ZIP 61301
Phone 815 780-2525
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/1/2024
Certificate Expiration Date 9/30/2026
Facility Type Other - APRN CLINIC OFFICE
Lab Director JENNIFER L. OLESEN

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