14D0870038 CLIA NUMBER - COMMUNITYHEALTH NFP

Laboratory Demographics

CLIA Number: 14D0870038

Facility Name: COMMUNITYHEALTH NFP

Facility Address:
2611 W CHICAGO AVE
CHICAGO, IL
ZIP 60622
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Facility Phone Number: 773 395-9900

Facility Type: Community Clinic

Certificate Type: Microscopy

NPI Number: 1295947430

Taxonomy: 261QC1500X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D0870038
LAB Type	Community Clinic
Facility Name	COMMUNITYHEALTH NFP
Street	2611 W CHICAGO AVE
City	CHICAGO
State	IL
ZIP	60622
Phone	773 395-9900
CertificateType	3
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	PPMP

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