14D1039695 CLIA NUMBER - MISERICORDIA HOME

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Field Name	Field Value
CLIA Number	14D1039695
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	MISERICORDIA HOME
Street	6300 N RIDGE
City	CHICAGO
State	IL
ZIP	60660
Phone	7732734127
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	4/20/2025
Certificate Expiration Date	4/19/2027
Facility Type	Intermediate Care Facility for Mentally Retarded
Lab Director	PAMELLA A. BRYIER

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This page was last updated on: 5/18/2026