14D1099722 CLIA NUMBER - ANDRZEJ GACEK MEDICAL LLC

Laboratory Demographics

  • CLIA Code: 14D1099722
  • Facility Name: ANDRZEJ GACEK MEDICAL LLC
  • Facility Address: 5901 N MILWAUKEE AVE, STE D
    CHICAGO, IL
    ZIP 60630
  • Facility Phone: 773 631-1300
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANDRZEJ GACEK
  • NPI Number: 1871543694
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D1099722
LAB Type Physician Office
Facility Name ANDRZEJ GACEK MEDICAL LLC
Street 5901 N MILWAUKEE AVE, STE D
City CHICAGO
State IL
ZIP 60630
Phone 773 631-1300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/20/2025
Certificate Expiration Date 5/19/2027
Facility Type Physician Office
Lab Director ANDRZEJ GACEK

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