14D0425767 CLIA NUMBER - DIAMOND HEADACHE CLINIC

Laboratory Demographics

  • CLIA Code: 14D0425767
  • Facility Name: DIAMOND HEADACHE CLINIC
  • Facility Address: 1460 N HALSTED, STE 501
    CHICAGO, IL
    ZIP 60642
  • Facility Phone: 773 388-6390
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MERLE L. DIAMOND
  • NPI Number: 1912027665
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 14D0425767
LAB Type Physician Office
Facility Name DIAMOND HEADACHE CLINIC
Street 1460 N HALSTED, STE 501
City CHICAGO
State IL
ZIP 60642
Phone 773 388-6390
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director MERLE L. DIAMOND

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