14D0709494 CLIA NUMBER - GLENVIEW DIALYSIS CENTER

Laboratory Demographics

CLIA Number: 14D0709494

Facility Name: GLENVIEW DIALYSIS CENTER

Facility Address:
4248 COMMERCIAL WAY
GLENVIEW, IL
ZIP 60025
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Facility Phone Number: 847 824-2006

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1932214772

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D0709494
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	GLENVIEW DIALYSIS CENTER
Street	4248 COMMERCIAL WAY
City	GLENVIEW
State	IL
ZIP	60025
Phone	847 824-2006
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