14D0704284 CLIA NUMBER - GLENDALE HEIGHTS HEALTHCARE CENTER

Laboratory Demographics

  • CLIA Code: 14D0704284
  • Facility Name: GLENDALE HEIGHTS HEALTHCARE CENTER
  • Facility Address: 113 W LAKE ST
    BLOOMINGDALE, IL
    ZIP 60108
  • Facility Phone: 630 894-8600
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: IMELDA A. SIA MD
  • NPI Number: 1740404680
  • Taxonomy: 207QH0002X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D0704284
LAB Type Physician Office
Facility Name GLENDALE HEIGHTS HEALTHCARE CENTER
Street 113 W LAKE ST
City BLOOMINGDALE
State IL
ZIP 60108
Phone 630 894-8600
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director IMELDA A. SIA MD

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