14D0992792 CLIA NUMBER - ASTHMA AND ALLERGY CENTER OF CHICAGO

Laboratory Demographics

CLIA Number: 14D0992792

Facility Name: ASTHMA AND ALLERGY CENTER OF CHICAGO

Facility Address:
7420 CENTRAL AVE - STE 2020
RIVER FOREST, IL
ZIP 60305
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Facility Phone Number: 708 695-4259

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1861503153

Taxonomy: 207KA0200X - Allergy & Immunology
A physician who specializes in the diagnosis, treatment, and management of allergies. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	14D0992792
LAB Type	Physician Office
Facility Name	ASTHMA AND ALLERGY CENTER OF CHICAGO
Street	7420 CENTRAL AVE - STE 2020
City	RIVER FOREST
State	IL
ZIP	60305
Phone	708 695-4259
CertificateType	4
CertificateEffectiveDate	10/25/2023
CertificateExpirationDate	10/24/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024