14D2003765 CLIA NUMBER - WELLNESS SPECIALIST CORPORATION HOME HEALTH CARE

Laboratory Demographics

  • CLIA Code: 14D2003765
  • Facility Name: WELLNESS SPECIALIST CORPORATION HOME HEALTH CARE
  • Facility Address: 330 E ROOSEVELT RD, STE 2D
    LOMBARD, IL
    ZIP 60148
  • Facility Phone: 630 652-0556
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: IRENE G. GONZAGA
  • NPI Number: 1760714448
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 14D2003765
LAB Type Home Health Agency
Facility Name WELLNESS SPECIALIST CORPORATION HOME HEALTH CARE
Street 330 E ROOSEVELT RD, STE 2D
City LOMBARD
State IL
ZIP 60148
Phone 630 652-0556
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/18/2024
Certificate Expiration Date 2/17/2026
Facility Type Home Health Agency
Lab Director IRENE G. GONZAGA

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