14D1091592 CLIA NUMBER - AUSTIN HEALTH CTR OF COOK COUNTY- MOBILE LAB

Laboratory Demographics

  • CLIA Code: 14D1091592
  • Facility Name: AUSTIN HEALTH CTR OF COOK COUNTY- MOBILE LAB
  • Facility Address: 4800 W CHICAGO AVE
    CHICAGO, IL
    ZIP 60651
  • Facility Phone: 773 826-9919
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: NEVENKA MARIC MD
  • NPI Number: 1568093557
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D1091592
LAB Type Independent
Facility Name AUSTIN HEALTH CTR OF COOK COUNTY- MOBILE LAB
Street 4800 W CHICAGO AVE
City CHICAGO
State IL
ZIP 60651
Phone 773 826-9919
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/5/2024
Certificate Expiration Date 11/4/2026
Facility Type Independent
Lab Director NEVENKA MARIC MD

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