14D0887883 CLIA NUMBER - BRYN MAWR CARE

Laboratory Demographics

  • CLIA Code: 14D0887883
  • Facility Name: BRYN MAWR CARE
  • Facility Address: 5547 NORTH KENMORE
    CHICAGO, IL
    ZIP 60640
  • Facility Phone: 773 561-7040
  • Facility Type: Other - SPEC MENTAL HEALTH FAC
  • Facility Type: Waiver
  • Lab Director: CONOLA D. MCCALL
  • NPI Number: 1891790242
  • Taxonomy: 310500000X - Intermediate Care Facility, Mental Illness

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CLIA Record

Field Name Field Value
CLIA Number 14D0887883
LAB Type Other - SPEC MENTAL HEALTH FAC
Facility Name BRYN MAWR CARE
Street 5547 NORTH KENMORE
City CHICAGO
State IL
ZIP 60640
Phone 773 561-7040
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/20/2024
Certificate Expiration Date 6/19/2026
Facility Type Other - SPEC MENTAL HEALTH FAC
Lab Director CONOLA D. MCCALL

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