14D1009642 CLIA NUMBER - PHYSICIANS IMMEDIATE CARE

Laboratory Demographics

  • CLIA Code: 14D1009642
  • Facility Name: PHYSICIANS IMMEDIATE CARE
  • Facility Address: 4211 N CICERO AVE
    CHICAGO, IL
    ZIP 60641
  • Facility Phone: 773 794-1000
  • Facility Type: Other - URGENT CARE
  • Facility Type: Waiver
  • Lab Director: ROBERT BIERNBAUM
  • NPI Number: 1366000648
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D1009642
LAB Type Other - URGENT CARE
Facility Name PHYSICIANS IMMEDIATE CARE
Street 4211 N CICERO AVE
City CHICAGO
State IL
ZIP 60641
Phone 773 794-1000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/20/2025
Certificate Expiration Date 2/19/2027
Facility Type Other - URGENT CARE
Lab Director ROBERT BIERNBAUM

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