14D1003959 CLIA NUMBER - CONCENTRA IMMEDIATE CARE - ASHLAND / 55

Laboratory Demographics

CLIA Number: 14D1003959

Facility Name: CONCENTRA IMMEDIATE CARE - ASHLAND / 55

Facility Address:
3145 S ASHLAND AVE STE 110
CHICAGO, IL
ZIP 60608
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Facility Phone Number: (773) 254-5516

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1316388002

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D1003959
LAB Type	PHYSICIAN OFFICE
Facility Name	CONCENTRA IMMEDIATE CARE - ASHLAND / 55
Street	3145 S ASHLAND AVE STE 110
City	CHICAGO
State	IL
ZIP	60608
Phone	(773) 254-5516

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This page was last updated on: 5/11/2023