14D0872237 CLIA NUMBER - PRIMECARE WEST TOWN HEALTH CENTER

Laboratory Demographics

CLIA Number: 14D0872237

Facility Name: PRIMECARE WEST TOWN HEALTH CENTER

Facility Address:
1431 W WESTERN AVE - STE 406
CHICAGO, IL
ZIP 60622
Get Directions

Facility Phone Number: 314 800-6161

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy

NPI Number: 1871117937

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D0872237
LAB Type	Federally Qualified Health Center
Facility Name	PRIMECARE WEST TOWN HEALTH CENTER
Street	1431 W WESTERN AVE - STE 406
City	CHICAGO
State	IL
ZIP	60622
Phone	314 800-6161
CertificateType	3
CertificateEffectiveDate	6/11/2023
CertificateExpirationDate	6/10/2025
FacilityType	PPMP

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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