14D0709488 CLIA NUMBER - FRESENIUS MEDICAL CARE CHICAGO

Laboratory Demographics

CLIA Number: 14D0709488

Facility Name: FRESENIUS MEDICAL CARE CHICAGO

Facility Address:
1806 W HUBBARD ST
CHICAGO, IL
ZIP 60622
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Facility Phone Number: 312 243-1139

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1467907196

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D0709488
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FRESENIUS MEDICAL CARE CHICAGO
Street	1806 W HUBBARD ST
City	CHICAGO
State	IL
ZIP	60622
Phone	312 243-1139
CertificateType	4
CertificateEffectiveDate	11/19/2023
CertificateExpirationDate	11/18/2025
FacilityType	Waiver

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