14D2013909 CLIA NUMBER - ACCREDITED AMBULATORY CARE LLC

Laboratory Demographics

  • CLIA Code: 14D2013909
  • Facility Name: ACCREDITED AMBULATORY CARE LLC
  • Facility Address: 1212 N LA SALLE ST, STE 100
    CHICAGO, IL
    ZIP 60610
  • Facility Phone: 312 943-7246
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GEOFFREY DIXON MD
  • NPI Number: 1174837082
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2013909
LAB Type Physician Office
Facility Name ACCREDITED AMBULATORY CARE LLC
Street 1212 N LA SALLE ST, STE 100
City CHICAGO
State IL
ZIP 60610
Phone 312 943-7246
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/27/2024
Certificate Expiration Date 9/26/2026
Facility Type Physician Office
Lab Director GEOFFREY DIXON MD

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