14D0677923 CLIA NUMBER - INFANT WELFARE SOCIETY OF CHICAGO

Laboratory Demographics

CLIA Number: 14D0677923

Facility Name: INFANT WELFARE SOCIETY OF CHICAGO

Facility Address:
3600 W FULLERTON AVE
CHICAGO, IL
ZIP 60647
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Facility Phone Number: 773 782-2800

Facility Type: Community Clinic

Certificate Type: Microscopy

NPI Number: 1497872543

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D0677923
LAB Type	Community Clinic
Facility Name	INFANT WELFARE SOCIETY OF CHICAGO
Street	3600 W FULLERTON AVE
City	CHICAGO
State	IL
ZIP	60647
Phone	773 782-2800
CertificateType	3
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	PPMP

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This page was last updated on: 4/23/2024