14D0948200 CLIA NUMBER - SINAI MED GROUP AT SINAI COMMUNITY INSTITUTE

Laboratory Demographics

CLIA Number: 14D0948200

Facility Name: SINAI MED GROUP AT SINAI COMMUNITY INSTITUTE

Facility Address:
2653 W OGDEN AVE, STE 3-A
CHICAGO, IL
ZIP 60608
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Facility Phone Number: 773 257-6463

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1760721955

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	14D0948200
LAB Type	Physician Office
Facility Name	SINAI MED GROUP AT SINAI COMMUNITY INSTITUTE
Street	2653 W OGDEN AVE, STE 3-A
City	CHICAGO
State	IL
ZIP	60608
Phone	773 257-6463
CertificateType	3
CertificateEffectiveDate	7/2/2022
CertificateExpirationDate	7/1/2024
FacilityType	PPMP

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This page was last updated on: 4/23/2024