14D0684494 CLIA NUMBER - CHURCH CREEK

Laboratory Demographics

CLIA Number: 14D0684494

Facility Name: CHURCH CREEK

Facility Address:
1250 WEST CENTRAL ROAD
ARLINGTON HEIGHTS, IL
ZIP 60005
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Facility Phone Number: 847 506-3200

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1912962796

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	14D0684494
LAB Type	Assisted Living Facility
Facility Name	CHURCH CREEK
Street	1250 WEST CENTRAL ROAD
City	ARLINGTON HEIGHTS
State	IL
ZIP	60005
Phone	847 506-3200
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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