14D1024748 CLIA NUMBER - FAMILY MED CARE CENTER SC

Laboratory Demographics

CLIA Number: 14D1024748

Facility Name: FAMILY MED CARE CENTER SC

Facility Address:
3360 W 95TH ST
EVERGREEN PARK, IL
ZIP 60805
Get Directions

Facility Phone Number: 708 423-3242

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1891733507

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	14D1024748
LAB Type	Physician Office
Facility Name	FAMILY MED CARE CENTER SC
Street	3360 W 95TH ST
City	EVERGREEN PARK
State	IL
ZIP	60805
Phone	708 423-3242
CertificateType	4
CertificateEffectiveDate	4/21/2024
CertificateExpirationDate	4/20/2026
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

This page was last updated on: 4/23/2024