14D1029861 CLIA NUMBER - NORTH RIVERSIDE HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 14D1029861
  • Facility Name: NORTH RIVERSIDE HEALTH CENTER
  • Facility Address: 1800 S HARLEM
    NORTH RIVERSIDE, IL
    ZIP 60546
  • Facility Phone: 708 783-9800
  • Facility Type: Community Clinic
  • Facility Type: Microscopy
  • Lab Director: DANIEL VITTUM M D
  • NPI Number: 1235507583
  • Taxonomy: 122300000X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 14D1029861
LAB Type Community Clinic
Facility Name NORTH RIVERSIDE HEALTH CENTER
Street 1800 S HARLEM
City NORTH RIVERSIDE
State IL
ZIP 60546
Phone 708 783-9800
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/25/2024
Certificate Expiration Date 8/24/2026
Facility Type Community Clinic
Lab Director DANIEL VITTUM M D

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