14D0888086 CLIA NUMBER - GRASMERE PLACE

Laboratory Demographics

  • CLIA Code: 14D0888086
  • Facility Name: GRASMERE PLACE
  • Facility Address: 4621 N SHERIDAN RD
    CHICAGO, IL
    ZIP 60640
  • Facility Phone: 773 334-6601
  • Facility Type: Other - SPECIALIZED MENTAL HEALTH
  • Facility Type: Waiver
  • Lab Director: LAURA FELICIANO-DIXON
  • NPI Number: 1932224243
  • Taxonomy: 310500000X - Intermediate Care Facility, Mental Illness

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CLIA Record

Field Name Field Value
CLIA Number 14D0888086
LAB Type Other - SPECIALIZED MENTAL HEALTH
Facility Name GRASMERE PLACE
Street 4621 N SHERIDAN RD
City CHICAGO
State IL
ZIP 60640
Phone 773 334-6601
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/22/2024
Certificate Expiration Date 6/21/2026
Facility Type Other - SPECIALIZED MENTAL HEALTH
Lab Director LAURA FELICIANO-DIXON

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