14D1020750 CLIA NUMBER - GARFIELD KIDNEY CENTER TOTAL RENAL CARE INC

Laboratory Demographics

  • CLIA Code: 14D1020750
  • Facility Name: GARFIELD KIDNEY CENTER TOTAL RENAL CARE INC
  • Facility Address: 414 N HOMAN
    CHICAGO, IL
    ZIP 60624
  • Facility Phone: 773 265-0750
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: OGBONNAYA E. ANEZIOKORO M D
  • NPI Number: 1730519190
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D1020750
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name GARFIELD KIDNEY CENTER TOTAL RENAL CARE INC
Street 414 N HOMAN
City CHICAGO
State IL
ZIP 60624
Phone 773 265-0750
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/31/2023
Certificate Expiration Date 12/30/2025
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director OGBONNAYA E. ANEZIOKORO M D

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