14D2309748 CLIA NUMBER - GOLDWATER CARE SPRING VALLEY

Laboratory Demographics

  • CLIA Code: 14D2309748
  • Facility Name: GOLDWATER CARE SPRING VALLEY
  • Facility Address: 1300 N GREENWOOD ST
    SPRING VALLEY, IL
    ZIP 61362
  • Facility Phone: 815 664-4708
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: LORI A. WALSH
  • NPI Number: 1932950839
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 14D2309748
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name GOLDWATER CARE SPRING VALLEY
Street 1300 N GREENWOOD ST
City SPRING VALLEY
State IL
ZIP 61362
Phone 815 664-4708
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/20/2024
Certificate Expiration Date 8/19/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director LORI A. WALSH

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