CLIA lab
CLIA 14D2097494: Premise Health of Illinois Medical, SC
Countryside, IL. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 14D2097494 belongs to Premise Health of Illinois Medical, SC in Countryside, IL.
Certificate of Waiver, effective June 17, 2025, expires June 16, 2027.
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 17, 2025
- Certificate expiration
- June 16, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- June 17, 2015
- Facility type
- Other practitioner
- Ownership (control type)
- Proprietary
- 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
- 14D2097494
- Lab name
- Premise Health of Illinois Medical, SC
- Address
- 6150 Joliet Rd, Ste Ohc, Countryside, IL 60525
- Phone
- (708) 485-2273
- Fax
- (708) 352-0845
Annual test volume the lab reported
- Waived tests
- 1,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Countryside, IL
- Adult Medicine PhysiciansCertificate of Waiver, Physician office14D1053417
- All Star Pediatrics PCCertificate of Waiver, Physician office14D0421526
- Allbest Home Health Care IncCertificate of Waiver, Home health agency14D0888160
- Country Family PracticeCertificate of Waiver, Physician office14D2033863
- Osco Drug #0754Certificate of Waiver, Pharmacy14D1032952
- Physicians Immediate CareCertificate of Waiver, Other14D2259320
- Workright Occupational Health ServicesCertificate of Waiver, Other14D0899391
Related
Questions
What is the CLIA number for Premise Health of Illinois Medical, SC in Countryside?
14D2097494, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Premise Health of Illinois Medical, SC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 14D2097494 expire?
The CMS file lists June 16, 2027 as the certificate expiration date; the certificate took effect June 17, 2025.