14D1058579 CLIA NUMBER - ZACHARY HOUSE EAST AVE

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Field Name	Field Value
CLIA Number	14D1058579
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	ZACHARY HOUSE EAST AVE
Street	1102 EAST AVE
City	STREAMWOOD
State	IL
ZIP	60107
Phone	630 483-0537
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	9/8/2024
Certificate Expiration Date	9/7/2026
Facility Type	Intermediate Care Facility for Mentally Retarded
Lab Director	DONITA A. LINK

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