14D1102597 CLIA NUMBER - SKOKIE FAMILY CLINIC & LASER CARE CENTER

Laboratory Demographics

CLIA Number: 14D1102597

Facility Name: SKOKIE FAMILY CLINIC & LASER CARE CENTER

Facility Address:
8301 SKOKIE BLVD
SKOKIE, IL
ZIP 60077
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Facility Phone Number: 847 674-0455

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1114250875

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	14D1102597
LAB Type	Physician Office
Facility Name	SKOKIE FAMILY CLINIC & LASER CARE CENTER
Street	8301 SKOKIE BLVD
City	SKOKIE
State	IL
ZIP	60077
Phone	847 674-0455
CertificateType	4
CertificateEffectiveDate	10/28/2022
CertificateExpirationDate	10/27/2024
FacilityType	Waiver

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