14D1064004 CLIA NUMBER - FAMILY GUIDANCE CENTERS INC

Laboratory Demographics

CLIA Number: 14D1064004

Facility Name: FAMILY GUIDANCE CENTERS INC

Facility Address:
310 W CHICAGO AVE
CHICAGO, IL
ZIP 60654
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Facility Phone Number: 312 943-6545

Facility Type: Other - OPIOID TREATMENT CENTER

Certificate Type: Waiver

NPI Number: 1124102611

Taxonomy: 261QM2800X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.

CLIA Record

Field Name	Field Value
CLIA Number	14D1064004
LAB Type	Other - OPIOID TREATMENT CENTER
Facility Name	FAMILY GUIDANCE CENTERS INC
Street	310 W CHICAGO AVE
City	CHICAGO
State	IL
ZIP	60654
Phone	312 943-6545
CertificateType	4
CertificateEffectiveDate	1/26/2023
CertificateExpirationDate	1/25/2025
FacilityType	Waiver

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