14D1016004 CLIA NUMBER - BEVERLY DIALYSIS RENAL LIFE LINK INC

Laboratory Demographics

  • CLIA Code: 14D1016004
  • Facility Name: BEVERLY DIALYSIS RENAL LIFE LINK INC
  • Facility Address: 8109 SOUTH WESTERN AVE
    CHICAGO, IL
    ZIP 60620
  • Facility Phone: 773 778-0173
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: JAMES J. RYDEL
  • NPI Number: 1215023338
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D1016004
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name BEVERLY DIALYSIS RENAL LIFE LINK INC
Street 8109 SOUTH WESTERN AVE
City CHICAGO
State IL
ZIP 60620
Phone 773 778-0173
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/18/2025
Certificate Expiration Date 8/17/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director JAMES J. RYDEL

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