14D2285379 CLIA NUMBER - MODERN HEALTH LLC

Laboratory Demographics

  • CLIA Code: 14D2285379
  • Facility Name: MODERN HEALTH LLC
  • Facility Address: 2440 HIGHVIEW ST
    SPRING GROVE, IL
    ZIP 60081
  • Facility Phone: 815 900-7330
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NICOLE J. HENDRICKSON
  • NPI Number: 1275231276
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2285379
LAB Type Physician Office
Facility Name MODERN HEALTH LLC
Street 2440 HIGHVIEW ST
City SPRING GROVE
State IL
ZIP 60081
Phone 815 900-7330
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/11/2025
Certificate Expiration Date 7/10/2027
Facility Type Physician Office
Lab Director NICOLE J. HENDRICKSON

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