14D1059043 CLIA NUMBER - MARK CHIEN M D L L C

Laboratory Demographics

  • CLIA Code: 14D1059043
  • Facility Name: MARK CHIEN M D L L C
  • Facility Address: 680 N LAKE SHORE DRIVE, SUITE 118
    CHICAGO, IL
    ZIP 60611
  • Facility Phone: 312 503-6000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARK C. CHIEN
  • NPI Number: 1356374383
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D1059043
LAB Type Physician Office
Facility Name MARK CHIEN M D L L C
Street 680 N LAKE SHORE DRIVE, SUITE 118
City CHICAGO
State IL
ZIP 60611
Phone 312 503-6000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/20/2024
Certificate Expiration Date 9/19/2026
Facility Type Physician Office
Lab Director MARK C. CHIEN

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