14D2209074 CLIA NUMBER - ST ANTHONY OF LANSING

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Laboratory Demographics

CLIA Number: 14D2209074

Facility Name: ST ANTHONY OF LANSING

Facility Address:
3025 SPRING LAKE DR
LANSING, IL
ZIP 60438
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Facility Phone Number: 708 474-6100

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1376978106

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	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
CertificateType	4
CertificateEffectiveDate	1/11/2023
CertificateExpirationDate	1/10/2025
FacilityType	Waiver

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