14D1040195 CLIA NUMBER - ORR ADOLESCENT HEALTH CENTER

Laboratory Demographics

CLIA Number: 14D1040195

Facility Name: ORR ADOLESCENT HEALTH CENTER

Facility Address:
730 N PULASKI-ROOM 109
CHICAGO, IL
ZIP 60624
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Facility Phone Number: 773 534-8924

Facility Type: School/Student Health Service

Certificate Type: Microscopy

NPI Number: 1902239809

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	14D1040195
LAB Type	School/Student Health Service
Facility Name	ORR ADOLESCENT HEALTH CENTER
Street	730 N PULASKI-ROOM 109
City	CHICAGO
State	IL
ZIP	60624
Phone	773 534-8924
CertificateType	3
CertificateEffectiveDate	5/3/2023
CertificateExpirationDate	5/2/2025
FacilityType	PPMP

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