14D2236768 CLIA NUMBER - HEALTHY MEDICAL INC

Laboratory Demographics

  • CLIA Code: 14D2236768
  • Facility Name: HEALTHY MEDICAL INC
  • Facility Address: 805 N KENNEDY DR - STE 2
    KANKAKEE, IL
    ZIP 60901
  • Facility Phone: 815 450-5504
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: MICHELLE R. AXIUM
  • NPI Number: 1285232991
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2236768
LAB Type Community Clinic
Facility Name HEALTHY MEDICAL INC
Street 805 N KENNEDY DR - STE 2
City KANKAKEE
State IL
ZIP 60901
Phone 815 450-5504
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/20/2025
Certificate Expiration Date 9/19/2027
Facility Type Community Clinic
Lab Director MICHELLE R. AXIUM

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