14D1001096 CLIA NUMBER - CONCENTRA - RIVER WEST

Laboratory Demographics

  • CLIA Code: 14D1001096
  • Facility Name: CONCENTRA - RIVER WEST
  • Facility Address: 1030 W CHICAGO AVE
    CHICAGO, IL
    ZIP 60642
  • Facility Phone: 312 243-1574
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CYNTHIA ROSS
  • NPI Number: 1033367941
  • Taxonomy: 261QH0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D1001096
LAB Type Physician Office
Facility Name CONCENTRA - RIVER WEST
Street 1030 W CHICAGO AVE
City CHICAGO
State IL
ZIP 60642
Phone 312 243-1574
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/8/2025
Certificate Expiration Date 4/7/2027
Facility Type Physician Office
Lab Director CYNTHIA ROSS

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