14D1081723 CLIA NUMBER - HAZEL CREST COMMUNITY HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 14D1081723
  • Facility Name: HAZEL CREST COMMUNITY HEALTH CENTER
  • Facility Address: 17850 S KEDZIE AVE - STE 1150
    HAZEL CREST, IL
    ZIP 60429
  • Facility Phone: 708 747-7677
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: GENERAL HOOD M D
  • NPI Number: 1851560601
  • Taxonomy: 251300000X - Local Education Agency (LEA)

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CLIA Record

Field Name Field Value
CLIA Number 14D1081723
LAB Type Federally Qualified Health Center
Facility Name HAZEL CREST COMMUNITY HEALTH CENTER
Street 17850 S KEDZIE AVE - STE 1150
City HAZEL CREST
State IL
ZIP 60429
Phone 708 747-7677
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 3/25/2024
Certificate Expiration Date 3/24/2026
Facility Type Federally Qualified Health Center
Lab Director GENERAL HOOD M D

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