14D2000338 CLIA NUMBER - LOYOLA MEDICINE HOME CARE AND HOSPICE

Laboratory Demographics

  • CLIA Code: 14D2000338
  • Facility Name: LOYOLA MEDICINE HOME CARE AND HOSPICE
  • Facility Address: 2301 WEST 22ND ST, STE 107
    OAK BROOK, IL
    ZIP 60523
  • Facility Phone: 630 861-5200
  • Facility Type: Other - HOME HEALTH AND HOSPICE
  • Facility Type: Waiver
  • Lab Director: ALAN R. TAGO
  • NPI Number: 1003919101
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 14D2000338
LAB Type Other - HOME HEALTH AND HOSPICE
Facility Name LOYOLA MEDICINE HOME CARE AND HOSPICE
Street 2301 WEST 22ND ST, STE 107
City OAK BROOK
State IL
ZIP 60523
Phone 630 861-5200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/25/2023
Certificate Expiration Date 11/24/2025
Facility Type Other - HOME HEALTH AND HOSPICE
Lab Director ALAN R. TAGO

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