14D0945965 CLIA NUMBER - PILSEN COMMUNITY PEDIATRICS S C

Laboratory Demographics

  • CLIA Code: 14D0945965
  • Facility Name: PILSEN COMMUNITY PEDIATRICS S C
  • Facility Address: 2738 W CERMAK RD
    CHICAGO, IL
    ZIP 60608
  • Facility Phone: 773 376-1906
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: GUSTAVO E. OROZA M D
  • NPI Number: 1760561617
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 14D0945965
LAB Type Physician Office
Facility Name PILSEN COMMUNITY PEDIATRICS S C
Street 2738 W CERMAK RD
City CHICAGO
State IL
ZIP 60608
Phone 773 376-1906
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 5/14/2024
Certificate Expiration Date 5/13/2026
Facility Type Physician Office
Lab Director GUSTAVO E. OROZA M D

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