14D0868212 CLIA NUMBER - CHRISTIAN COMMUNITY HEALTH CENTER

Laboratory Demographics

CLIA Number: 14D0868212

Facility Name: CHRISTIAN COMMUNITY HEALTH CENTER

Facility Address:
9718 S HALSTED ST
CHICAGO, IL
ZIP 60628
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Facility Phone Number: 773 233-4100

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy

NPI Number: 1912170457

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D0868212
LAB Type	Federally Qualified Health Center
Facility Name	CHRISTIAN COMMUNITY HEALTH CENTER
Street	9718 S HALSTED ST
City	CHICAGO
State	IL
ZIP	60628
Phone	773 233-4100
CertificateType	3
CertificateEffectiveDate	2/18/2024
CertificateExpirationDate	2/17/2026
FacilityType	PPMP

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