14D2279461 CLIA NUMBER - GEODE HEALTH - ROCKFORD

Laboratory Demographics

  • CLIA Code: 14D2279461
  • Facility Name: GEODE HEALTH - ROCKFORD
  • Facility Address: 1639 N ALPINE RD
    ROCKFORD, IL
    ZIP 61107
  • Facility Phone: 779 771-6466
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: AMANDA STILES
  • NPI Number: 1487751335
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 14D2279461
LAB Type Independent
Facility Name GEODE HEALTH - ROCKFORD
Street 1639 N ALPINE RD
City ROCKFORD
State IL
ZIP 61107
Phone 779 771-6466
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/3/2025
Certificate Expiration Date 4/2/2027
Facility Type Independent
Lab Director AMANDA STILES

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