14D2209074 CLIA NUMBER - ST ANTHONY OF LANSING

Laboratory Demographics

  • CLIA Code: 14D2209074
  • Facility Name: ST ANTHONY OF LANSING
  • Facility Address: 3025 SPRING LAKE DR
    LANSING, IL
    ZIP 60438
  • Facility Phone: 708 474-6100
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: TENEISHA PETERSON
  • NPI Number: 1376978106
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 14D2209074
LAB Type Assisted Living Facility
Facility Name ST ANTHONY OF LANSING
Street 3025 SPRING LAKE DR
City LANSING
State IL
ZIP 60438
Phone 708 474-6100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/11/2025
Certificate Expiration Date 1/10/2027
Facility Type Assisted Living Facility
Lab Director TENEISHA PETERSON

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