14D1097245 CLIA NUMBER - DOMINICAN UNIVERSITY WELLNESS CENTER

Laboratory Demographics

CLIA Number: 14D1097245

Facility Name: DOMINICAN UNIVERSITY WELLNESS CENTER

Facility Address:
7900 W DIVISION STREET, COGHLIN HALL, LL
RIVER FOREST, IL
ZIP 60305
Get Directions

Facility Phone Number: 708 524-6520

Facility Type: School/Student Health Service

Certificate Type: Waiver

NPI Number: 1477892446

Taxonomy: 261QS1000X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D1097245
LAB Type	School/Student Health Service
Facility Name	DOMINICAN UNIVERSITY WELLNESS CENTER
Street	7900 W DIVISION STREET, COGHLIN HALL, LL
City	RIVER FOREST
State	IL
ZIP	60305
Phone	708 524-6520
CertificateType	4
CertificateEffectiveDate	3/23/2023
CertificateExpirationDate	3/22/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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