14D1094993 CLIA NUMBER - ALDEN VILLAGE NORTH INC

Laboratory Demographics

CLIA Number: 14D1094993

Facility Name: ALDEN VILLAGE NORTH INC

Facility Address:
7464 N SHERIDAN ROAD
CHICAGO, IL
ZIP 60626
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Facility Phone Number: 773 338-0200

Facility Type: Intermediate Care Facility for Mentally Retarded

Certificate Type: Waiver

NPI Number: 1821453523

Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

CLIA Record

Field Name	Field Value
CLIA Number	14D1094993
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	ALDEN VILLAGE NORTH INC
Street	7464 N SHERIDAN ROAD
City	CHICAGO
State	IL
ZIP	60626
Phone	773 338-0200
CertificateType	4
CertificateEffectiveDate	1/30/2023
CertificateExpirationDate	1/29/2025
FacilityType	Waiver

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