14D0879083 CLIA NUMBER - BALMORAL NURSING HOME

Laboratory Demographics

  • CLIA Code: 14D0879083
  • Facility Name: BALMORAL NURSING HOME
  • Facility Address: 2055 W BALMORAL
    CHICAGO, IL
    ZIP 60625
  • Facility Phone: 773 561-8661
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: LEA JOYCE S. DE JESUS
  • NPI Number: 1770971160
  • Taxonomy: 332BX2000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 14D0879083
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name BALMORAL NURSING HOME
Street 2055 W BALMORAL
City CHICAGO
State IL
ZIP 60625
Phone 773 561-8661
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/10/2023
Certificate Expiration Date 11/9/2025
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director LEA JOYCE S. DE JESUS

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