14D1079694 CLIA NUMBER - CENTER FOR HEALTH AT PARK RIDGE LOYOLA UNIVERSITY MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 14D1079694
  • Facility Name: CENTER FOR HEALTH AT PARK RIDGE LOYOLA UNIVERSITY MEDICAL CENTER
  • Facility Address: 1ST FLOOR, STE 103 1030 W HIGGINS RD
    PARK RIDGE, IL
    ZIP 60068
  • Facility Phone: 708 327-7000
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: JOSHUA EVANS M D
  • NPI Number: 1417318700
  • Taxonomy: 101YM0800X - Counselor

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CLIA Record

Field Name Field Value
CLIA Number 14D1079694
LAB Type Community Clinic
Facility Name CENTER FOR HEALTH AT PARK RIDGE LOYOLA UNIVERSITY MEDICAL CENTER
Street 1ST FLOOR, STE 103 1030 W HIGGINS RD
City PARK RIDGE
State IL
ZIP 60068
Phone 708 327-7000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/20/2024
Certificate Expiration Date 6/19/2026
Facility Type Community Clinic
Lab Director JOSHUA EVANS M D

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