14D0724251 CLIA NUMBER - COTTAGE GROVE HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 14D0724251
  • Facility Name: COTTAGE GROVE HEALTH CENTER
  • Facility Address: 1645 COTTAGE GROVE AVE
    FORD HEIGHTS, IL
    ZIP 60411
  • Facility Phone: 708 753-5800
  • Facility Type: Community Clinic
  • Facility Type: Microscopy
  • Lab Director: ABHA SHARMA M D
  • NPI Number: 1760502439
  • Taxonomy: 261QP2300X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D0724251
LAB Type Community Clinic
Facility Name COTTAGE GROVE HEALTH CENTER
Street 1645 COTTAGE GROVE AVE
City FORD HEIGHTS
State IL
ZIP 60411
Phone 708 753-5800
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 Community Clinic
Lab Director ABHA SHARMA M D

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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