14D1080079 CLIA NUMBER - ELMHURST CLINIC ADDISON #200

Laboratory Demographics

CLIA Number: 14D1080079

Facility Name: ELMHURST CLINIC ADDISON #200

Facility Address:
303 W LAKE ST, #200
ADDISON, IL
ZIP 60101
Get Directions

Facility Phone Number: 331 221-5376

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1003046103

Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

CLIA Record

Field Name	Field Value
CLIA Number	14D1080079
LAB Type	Physician Office
Facility Name	ELMHURST CLINIC ADDISON #200
Street	303 W LAKE ST, #200
City	ADDISON
State	IL
ZIP	60101
Phone	331 221-5376
CertificateType	4
CertificateEffectiveDate	5/31/2022
CertificateExpirationDate	5/30/2024
FacilityType	Waiver

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