14D1069994 CLIA NUMBER - HAZELDEN CHICAGO

Laboratory Demographics

  • CLIA Code: 14D1069994
  • Facility Name: HAZELDEN CHICAGO
  • Facility Address: 867 N DEARBORN ST
    CHICAGO, IL
    ZIP 60610
  • Facility Phone: 312 631-7947
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: LAUREN FISH
  • NPI Number: 1700270964
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 14D1069994
LAB Type Comp. Outpatient Rehab Facility
Facility Name HAZELDEN CHICAGO
Street 867 N DEARBORN ST
City CHICAGO
State IL
ZIP 60610
Phone 312 631-7947
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/19/2025
Certificate Expiration Date 6/18/2027
Facility Type Comp. Outpatient Rehab Facility
Lab Director LAUREN FISH

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