14D1030579 CLIA NUMBER - ENGLEWOOD HEALTH CENTER

Laboratory Demographics

CLIA Number: 14D1030579

Facility Name: ENGLEWOOD HEALTH CENTER

Facility Address:
1135 WEST 69TH STREET
CHICAGO, IL
ZIP 60621
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Facility Phone Number: 773 483-6470

Facility Type: Community Clinic

Certificate Type: Microscopy

NPI Number: 1083882997

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	14D1030579
LAB Type	Community Clinic
Facility Name	ENGLEWOOD HEALTH CENTER
Street	1135 WEST 69TH STREET
City	CHICAGO
State	IL
ZIP	60621
Phone	773 483-6470
CertificateType	3
CertificateEffectiveDate	9/9/2022
CertificateExpirationDate	9/8/2024
FacilityType	PPMP

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