14D1026489 CLIA NUMBER - CONCENTRA IMMEDIATE CARE -BLOOMINGDALE AMERICAN CURRENT CARE P A CO

Laboratory Demographics

CLIA Number: 14D1026489

Facility Name: CONCENTRA IMMEDIATE CARE -BLOOMINGDALE AMERICAN CURRENT CARE P A CO

Facility Address:
211 E ARMY TRAIL RD
BLOOMINGDALE, IL
ZIP 60108
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Facility Phone Number: 630 582-8946

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1215378906

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D1026489
LAB Type	Physician Office
Facility Name	CONCENTRA IMMEDIATE CARE -BLOOMINGDALE AMERICAN CURRENT CARE P A CO
Street	211 E ARMY TRAIL RD
City	BLOOMINGDALE
State	IL
ZIP	60108
Phone	630 582-8946
CertificateType	3
CertificateEffectiveDate	12/20/2023
CertificateExpirationDate	12/19/2025
FacilityType	PPMP

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