14D0856173 CLIA NUMBER - PAULINA MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 14D0856173
  • Facility Name: PAULINA MEDICAL CLINIC
  • Facility Address: 6677 N LINCOLN AVE - STE 110
    LINCOLNWOOD, IL
    ZIP 60712
  • Facility Phone: 773 583-7793
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: ANDREA RENTEA
  • NPI Number: 1316103286
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 14D0856173
LAB Type Ancillary Testing Site in Health Care Center
Facility Name PAULINA MEDICAL CLINIC
Street 6677 N LINCOLN AVE - STE 110
City LINCOLNWOOD
State IL
ZIP 60712
Phone 773 583-7793
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Ancillary Testing Site in Health Care Center
Lab Director ANDREA RENTEA

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