14D1081352 CLIA NUMBER - PROACTIVE COMMUNITY SERVICES

Laboratory Demographics

  • CLIA Code: 14D1081352
  • Facility Name: PROACTIVE COMMUNITY SERVICES
  • Facility Address: 19740 GOVERNORS HWY - STE 118
    FLOSSMOOR, IL
    ZIP 60422
  • Facility Phone: 708 248-6166
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: EULA L. BURGE
  • NPI Number: 1174035059
  • Taxonomy: 261QC1500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D1081352
LAB Type Mobile Laboratory
Facility Name PROACTIVE COMMUNITY SERVICES
Street 19740 GOVERNORS HWY - STE 118
City FLOSSMOOR
State IL
ZIP 60422
Phone 708 248-6166
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/17/2024
Certificate Expiration Date 3/16/2026
Facility Type Mobile Laboratory
Lab Director EULA L. BURGE

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