CLIA lab
CLIA 14D1055712: Good Shepherd Manor Inc
Momence, IL. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 14D1055712 belongs to Good Shepherd Manor Inc in Momence, IL.
Certificate of Waiver, effective June 23, 2026, expires June 22, 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
- June 23, 2026
- Certificate expiration
- June 22, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- June 23, 2006
- Facility type
- Intermediate care facility for individuals with intellectual disabilities
- Ownership (control type)
- Religious affiliation
- 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
- 14D1055712
- Lab name
- Good Shepherd Manor Inc
- Address
- 4129 N State Route 1-17, Momence, IL 60954
- Phone
- (815) 472-3700
- Fax
- (815) 472-3092
Annual test volume the lab reported
- Waived tests
- 6,460
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Momence, IL
- DR Sunil K Shah D O, S C - MomenceCertificate of Waiver, Physician office14D2168378
- Momence Meadows Nursing & Rehab Center LLCCertificate of Waiver, Skilled nursing or nursing facility14D0954622
- Riverside Community Health of MomenceCertificate for Provider-Performed Microscopy Procedures, Physician office14D0429463
- Van Drunen FarmsCertificate of Waiver, Other14D2212079
Related
Questions
What is the CLIA number for Good Shepherd Manor Inc in Momence?
14D1055712, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Good Shepherd Manor Inc hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 14D1055712 expire?
The CMS file lists June 22, 2028 as the certificate expiration date; the certificate took effect June 23, 2026.