14D1029641 CLIA NUMBER - AUSTIN COMMUNITY KIDNEY CENTER

Laboratory Demographics

  • CLIA Code: 14D1029641
  • Facility Name: AUSTIN COMMUNITY KIDNEY CENTER
  • Facility Address: 4800 W CHICAGO AVENUE-2ND FLOOR
    CHICAGO, IL
    ZIP 60651
  • Facility Phone: 773 287-0680
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DAVID KRACKER
  • NPI Number: 1730294588
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D1029641
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name AUSTIN COMMUNITY KIDNEY CENTER
Street 4800 W CHICAGO AVENUE-2ND FLOOR
City CHICAGO
State IL
ZIP 60651
Phone 773 287-0680
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/20/2024
Certificate Expiration Date 8/19/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DAVID KRACKER

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