14D0709506 CLIA NUMBER - FRESENIUS KIDNEY CARE CHICAGO SKYWAY

Laboratory Demographics

CLIA Number: 14D0709506

Facility Name: FRESENIUS KIDNEY CARE CHICAGO SKYWAY

Facility Address:
1453 E 75TH ST
CHICAGO, IL
ZIP 60619
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Facility Phone Number: 773 493-6015

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1821421199

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D0709506
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FRESENIUS KIDNEY CARE CHICAGO SKYWAY
Street	1453 E 75TH ST
City	CHICAGO
State	IL
ZIP	60619
Phone	773 493-6015
CertificateType	4
CertificateEffectiveDate	2/17/2024
CertificateExpirationDate	2/16/2026
FacilityType	Waiver

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