14D1091365 CLIA NUMBER - PALOS COMMUNITY HOSPITAL DEPARTMENT OF PATHOLOGY AND LAB SERVICES

Laboratory Demographics

CLIA Number: 14D1091365

Facility Name: PALOS COMMUNITY HOSPITAL DEPARTMENT OF PATHOLOGY AND LAB SERVICES

Facility Address:
12251 SOUTH 80TH AVENUE
PALOS HEIGHTS, IL
ZIP 60463
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Facility Phone Number: 708 923-5076

Facility Type: Ancillary Testing Site in Health Care Center

Certificate Type: Waiver

NPI Number: 1851386692

Taxonomy: 282N00000X - General Acute Care Hospital
An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity.

CLIA Record

Field Name	Field Value
CLIA Number	14D1091365
LAB Type	Ancillary Testing Site in Health Care Center
Facility Name	PALOS COMMUNITY HOSPITAL DEPARTMENT OF PATHOLOGY AND LAB SERVICES
Street	12251 SOUTH 80TH AVENUE
City	PALOS HEIGHTS
State	IL
ZIP	60463
Phone	708 923-5076
CertificateType	4
CertificateEffectiveDate	10/30/2022
CertificateExpirationDate	10/29/2024
FacilityType	Waiver

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