14D0924545 CLIA NUMBER - HARTGROVE BEHAVIORAL HEALTH SYSTEM

Laboratory Demographics

  • CLIA Code: 14D0924545
  • Facility Name: HARTGROVE BEHAVIORAL HEALTH SYSTEM
  • Facility Address: 5730 W ROOSEVELT RD
    CHICAGO, IL
    ZIP 60644
  • Facility Phone: 773 413-1700
  • Facility Type: Hospital
  • Facility Type: Waiver
  • Lab Director: SHALINI PANDIYAN
  • NPI Number: 1255577540
  • Taxonomy: 2084P0804X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 14D0924545
LAB Type Hospital
Facility Name HARTGROVE BEHAVIORAL HEALTH SYSTEM
Street 5730 W ROOSEVELT RD
City CHICAGO
State IL
ZIP 60644
Phone 773 413-1700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/3/2025
Certificate Expiration Date 2/2/2027
Facility Type Hospital
Lab Director SHALINI PANDIYAN

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This page was last updated on: 6/4/2025