14D0701843 CLIA NUMBER - PINE CREST HEALTH CARE L L C

Laboratory Demographics

  • CLIA Code: 14D0701843
  • Facility Name: PINE CREST HEALTH CARE L L C
  • Facility Address: 3300 W 175TH ST
    HAZEL CREST, IL
    ZIP 60429
  • Facility Phone: 708 335-2400
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ZINA WARD
  • NPI Number: 1376840538
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 14D0701843
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PINE CREST HEALTH CARE L L C
Street 3300 W 175TH ST
City HAZEL CREST
State IL
ZIP 60429
Phone 708 335-2400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/29/2024
Certificate Expiration Date 1/28/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director ZINA WARD

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