14D0980721 CLIA NUMBER - ELISABETH I WALLNER MD SC

Laboratory Demographics

  • CLIA Code: 14D0980721
  • Facility Name: ELISABETH I WALLNER MD SC
  • Facility Address: 676 N ST CLAIR, STE 2250
    CHICAGO, IL
    ZIP 60611
  • Facility Phone: 312 926-0888
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ELISABETH I. WALLNER MD
  • NPI Number: 1912919440
  • Taxonomy: 207R00000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D0980721
LAB Type Physician Office
Facility Name ELISABETH I WALLNER MD SC
Street 676 N ST CLAIR, STE 2250
City CHICAGO
State IL
ZIP 60611
Phone 312 926-0888
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/13/2024
Certificate Expiration Date 6/12/2026
Facility Type Physician Office
Lab Director ELISABETH I. WALLNER MD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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