14D0976947 CLIA NUMBER - PHYSICIANS IMMEDIATE CARE PHYSICIANS IMMEDIATE CARE CHICAGO, LLC

Laboratory Demographics

  • CLIA Code: 14D0976947
  • Facility Name: PHYSICIANS IMMEDIATE CARE PHYSICIANS IMMEDIATE CARE CHICAGO, LLC
  • Facility Address: 1000 E RIVERSIDE BLVD
    LOVES PARK, IL
    ZIP 61111
  • Facility Phone: 815 633-4300
  • Facility Type: Other - URGENT CARE
  • Facility Type: Waiver
  • Lab Director: ROBERT BIERNBAUM
  • NPI Number: 1538499140
  • Taxonomy: 207P00000X - Emergency Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D0976947
LAB Type Other - URGENT CARE
Facility Name PHYSICIANS IMMEDIATE CARE PHYSICIANS IMMEDIATE CARE CHICAGO, LLC
Street 1000 E RIVERSIDE BLVD
City LOVES PARK
State IL
ZIP 61111
Phone 815 633-4300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/9/2025
Certificate Expiration Date 9/8/2027
Facility Type Other - URGENT CARE
Lab Director ROBERT BIERNBAUM

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