14D2321454 CLIA NUMBER - AVENUES AT ROYAL OAK

Laboratory Demographics

  • CLIA Code: 14D2321454
  • Facility Name: AVENUES AT ROYAL OAK
  • Facility Address: 605 E CHURCH ST
    KEWANEE, IL
    ZIP 61443
  • Facility Phone: 309 852-3389
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: LAURA MARTIN
  • NPI Number: 1174350482
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 14D2321454
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name AVENUES AT ROYAL OAK
Street 605 E CHURCH ST
City KEWANEE
State IL
ZIP 61443
Phone 309 852-3389
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/4/2025
Certificate Expiration Date 4/3/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director LAURA MARTIN

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