CLIA lab
CLIA 14D1034468: Prime Healthcare Medical Group, L L C
Kankakee, IL. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 14D1034468 belongs to Prime Healthcare Medical Group, L L C in Kankakee, IL.
Certificate of Waiver, effective July 22, 2026, expires July 21, 2028.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- July 22, 2026
- Certificate expiration
- July 21, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- December 3, 2004
- Facility type
- Physician office
- Ownership (control type)
- Private
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 14D1034468
- Lab name
- Prime Healthcare Medical Group, L L C
- Additional name
- Internal Med
- Address
- 555 W Court St - Ste 406B, Kankakee, IL 60901
- Phone
- (815) 936-5167
Annual test volume the lab reported
- Waived tests
- 750
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Asbury of Kankakee Supportive LivingCertificate of Waiver, Other14D2212505
- Ascension Living Heritage VillageCertificate of Waiver, Skilled nursing or nursing facility14D0965320
- Ascension Saint Mary EMSCertificate of Waiver, Ambulance14D0920075
- Azzarelli Outreach Clinic of ST Teresa ChurchCertificate of Waiver, Community clinic14D1061790
- B A S F Kankakee Medical DepartmentCertificate of Waiver, Other14D2068092
- Citadel Care Center of KankakeeCertificate of Waiver, Skilled nursing or nursing facility14D0858655
- Cvs/Pharmacy #02663Certificate of Waiver, Pharmacy14D2257869
- DR Brian OlofssonCertificate of Waiver, Physician office14D0876545
Related
Questions
What is the CLIA number for Prime Healthcare Medical Group, L L C in Kankakee?
14D1034468, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Prime Healthcare Medical Group, L L C hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 14D1034468 expire?
The CMS file lists July 21, 2028 as the certificate expiration date; the certificate took effect July 22, 2026.