14D0955821 CLIA NUMBER - WELLNESS HOME AT NORTHSTAR HEALTHCARE

Laboratory Demographics

  • CLIA Code: 14D0955821
  • Facility Name: WELLNESS HOME AT NORTHSTAR HEALTHCARE
  • Facility Address: 2835 N SHEFFIELD AVE - STE 500
    CHICAGO, IL
    ZIP 60657
  • Facility Phone: 773 296-2400
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANDRA MUNTEANU
  • NPI Number: 1083755474
  • Taxonomy: 305R00000X - Preferred Provider Organization

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CLIA Record

Field Name Field Value
CLIA Number 14D0955821
LAB Type Physician Office
Facility Name WELLNESS HOME AT NORTHSTAR HEALTHCARE
Street 2835 N SHEFFIELD AVE - STE 500
City CHICAGO
State IL
ZIP 60657
Phone 773 296-2400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/19/2025
Certificate Expiration Date 9/18/2027
Facility Type Physician Office
Lab Director ANDRA MUNTEANU

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