14D2317118 CLIA NUMBER - OSF HEALTHCARE SKMC - CENTER FOR HEALTH

Laboratory Demographics

  • CLIA Code: 14D2317118
  • Facility Name: OSF HEALTHCARE SKMC - CENTER FOR HEALTH
  • Facility Address: 102 S HENNEPIN AVE
    DIXON, IL
    ZIP 61021
  • Facility Phone: 815 288-7711
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL KOUIMELIS
  • NPI Number: 1508683590
  • Taxonomy: 282N00000X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 14D2317118
LAB Type Physician Office
Facility Name OSF HEALTHCARE SKMC - CENTER FOR HEALTH
Street 102 S HENNEPIN AVE
City DIXON
State IL
ZIP 61021
Phone 815 288-7711
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/17/2025
Certificate Expiration Date 1/16/2027
Facility Type Physician Office
Lab Director MICHAEL KOUIMELIS

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