14D1020529 CLIA NUMBER - ELMWOOD PARK IMMEDIATE HEALTH CARE CENTER LLC

Laboratory Demographics

  • CLIA Code: 14D1020529
  • Facility Name: ELMWOOD PARK IMMEDIATE HEALTH CARE CENTER LLC
  • Facility Address: 2333 N HARLEM AVE-SUITE 100
    CHICAGO, IL
    ZIP 60707
  • Facility Phone: 773 637-2333
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHARLES D. CAMPBELL
  • NPI Number: 1356396758
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D1020529
LAB Type Physician Office
Facility Name ELMWOOD PARK IMMEDIATE HEALTH CARE CENTER LLC
Street 2333 N HARLEM AVE-SUITE 100
City CHICAGO
State IL
ZIP 60707
Phone 773 637-2333
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/22/2023
Certificate Expiration Date 12/21/2025
Facility Type Physician Office
Lab Director CHARLES D. CAMPBELL

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