14D1073243 CLIA NUMBER - TAPESTRY 360 HEALTH

Laboratory Demographics

CLIA Number: 14D1073243

Facility Name: TAPESTRY 360 HEALTH

Facility Address:
2645 W LAWRENCE AVE
CHICAGO, IL
ZIP 60625
Get Directions

Facility Phone Number: 773 751-1824

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy

NPI Number: 1548634991

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D1073243
LAB Type	Federally Qualified Health Center
Facility Name	TAPESTRY 360 HEALTH
Street	2645 W LAWRENCE AVE
City	CHICAGO
State	IL
ZIP	60625
Phone	773 751-1824
CertificateType	3
CertificateEffectiveDate	9/5/2023
CertificateExpirationDate	9/4/2025
FacilityType	PPMP

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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