14D1018636 CLIA NUMBER - MONTCLARE DIALYSIS DAVITA

Laboratory Demographics

  • CLIA Code: 14D1018636
  • Facility Name: MONTCLARE DIALYSIS DAVITA
  • Facility Address: 7009 BELMONT AVE
    CHICAGO, IL
    ZIP 60634
  • Facility Phone: 253 272-1916
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: KENNETH A. KUZNETSKY
  • NPI Number: 1861461030
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D1018636
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name MONTCLARE DIALYSIS DAVITA
Street 7009 BELMONT AVE
City CHICAGO
State IL
ZIP 60634
Phone 253 272-1916
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/28/2023
Certificate Expiration Date 10/27/2025
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director KENNETH A. KUZNETSKY

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