14D0893962 CLIA NUMBER - CITY CENTER HEALTH CARE

Laboratory Demographics

  • CLIA Code: 14D0893962
  • Facility Name: CITY CENTER HEALTH CARE
  • Facility Address: 300 N OTTAWA ST
    JOLIET, IL
    ZIP 60432
  • Facility Phone: 815 726-0311
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHANTHI R. GOPI M D
  • NPI Number: 1245874635
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 14D0893962
LAB Type Physician Office
Facility Name CITY CENTER HEALTH CARE
Street 300 N OTTAWA ST
City JOLIET
State IL
ZIP 60432
Phone 815 726-0311
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/3/2024
Certificate Expiration Date 6/2/2026
Facility Type Physician Office
Lab Director SHANTHI R. GOPI M D

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