14D0950926 CLIA NUMBER - COUNTRY HILLS DIALYSIS

Laboratory Demographics

  • CLIA Code: 14D0950926
  • Facility Name: COUNTRY HILLS DIALYSIS
  • Facility Address: 4215 WEST 167TH ST
    COUNTRY CLUB HILLS, IL
    ZIP 60478
  • Facility Phone: 708 333-3516
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: KENNETH CLINE
  • NPI Number: 1073532420
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D0950926
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name COUNTRY HILLS DIALYSIS
Street 4215 WEST 167TH ST
City COUNTRY CLUB HILLS
State IL
ZIP 60478
Phone 708 333-3516
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/9/2024
Certificate Expiration Date 9/8/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director KENNETH CLINE

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