14D0940458 CLIA NUMBER - PCC SALUD FAMILY HEALTH

Laboratory Demographics

  • CLIA Code: 14D0940458
  • Facility Name: PCC SALUD FAMILY HEALTH
  • Facility Address: 5359 W FULLERTON AVE
    CHICAGO, IL
    ZIP 60639
  • Facility Phone: 773 836-2785
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: LIZBETH RODRIGUEZ
  • NPI Number: 1487670097
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D0940458
LAB Type Federally Qualified Health Center
Facility Name PCC SALUD FAMILY HEALTH
Street 5359 W FULLERTON AVE
City CHICAGO
State IL
ZIP 60639
Phone 773 836-2785
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 2/9/2025
Certificate Expiration Date 2/8/2027
Facility Type Federally Qualified Health Center
Lab Director LIZBETH RODRIGUEZ

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