14D0961574 CLIA NUMBER - LOYOLA UNIVERSITY WELLNESS CENTER

Laboratory Demographics

  • CLIA Code: 14D0961574
  • Facility Name: LOYOLA UNIVERSITY WELLNESS CENTER
  • Facility Address: 6439 NORTH SHERIDAN ROAD
    CHICAGO, IL
    ZIP 60626
  • Facility Phone: 773 508-2535
  • Facility Type: School/Student Health Service
  • Facility Type: Microscopy
  • Lab Director: JOAN HOLDEN APN ANP-BC
  • NPI Number: 1659951481
  • Taxonomy: 363LP2300X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 14D0961574
LAB Type School/Student Health Service
Facility Name LOYOLA UNIVERSITY WELLNESS CENTER
Street 6439 NORTH SHERIDAN ROAD
City CHICAGO
State IL
ZIP 60626
Phone 773 508-2535
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 6/10/2023
Certificate Expiration Date 6/9/2025
Facility Type School/Student Health Service
Lab Director JOAN HOLDEN APN ANP-BC

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This page was last updated on: 3/20/2025