14D0646491 CLIA NUMBER - GREENWOOD CARE

Laboratory Demographics

  • CLIA Code: 14D0646491
  • Facility Name: GREENWOOD CARE
  • Facility Address: 1406 CHICAGO AVE
    EVANSTON, IL
    ZIP 60201
  • Facility Phone: 847 328-6503
  • Facility Type: Intermediate Care Facility for Mentally Retarded
  • Facility Type: Waiver
  • Lab Director: DELVIN RYCHENER
  • NPI Number: 1295730679
  • Taxonomy: 310500000X - Intermediate Care Facility, Mental Illness

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CLIA Record

Field Name Field Value
CLIA Number 14D0646491
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name GREENWOOD CARE
Street 1406 CHICAGO AVE
City EVANSTON
State IL
ZIP 60201
Phone 847 328-6503
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 Intermediate Care Facility for Mentally Retarded
Lab Director DELVIN RYCHENER

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