14D1083652 CLIA NUMBER - ALIVIO MEDICAL CENTER

Laboratory Demographics

CLIA Number: 14D1083652

Facility Name: ALIVIO MEDICAL CENTER

Facility Address:
6447 W CERMAK
BERWYN, IL
ZIP 60402
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Facility Phone Number: 773 843-4205

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy

NPI Number: 1609264001

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D1083652
LAB Type	Federally Qualified Health Center
Facility Name	ALIVIO MEDICAL CENTER
Street	6447 W CERMAK
City	BERWYN
State	IL
ZIP	60402
Phone	773 843-4205
CertificateType	3
CertificateEffectiveDate	5/7/2024
CertificateExpirationDate	5/6/2026
FacilityType	PPMP

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