14D0994038 CLIA NUMBER - LINCOLN PEDIATRIC CENTER

Laboratory Demographics

  • CLIA Code: 14D0994038
  • Facility Name: LINCOLN PEDIATRIC CENTER
  • Facility Address: 5641 N LINCOLN AVE
    CHICAGO, IL
    ZIP 60659
  • Facility Phone: 773 728-4784
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOANN E. RUIZ MD
  • NPI Number: 1609836931
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 14D0994038
LAB Type Physician Office
Facility Name LINCOLN PEDIATRIC CENTER
Street 5641 N LINCOLN AVE
City CHICAGO
State IL
ZIP 60659
Phone 773 728-4784
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/24/2024
Certificate Expiration Date 1/23/2026
Facility Type Physician Office
Lab Director JOANN E. RUIZ MD

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