14D2014077 CLIA NUMBER - WOODLAWN DIALYSIS (D/B/A) TOTAL RENAL CARE INC

Laboratory Demographics

  • CLIA Code: 14D2014077
  • Facility Name: WOODLAWN DIALYSIS (D/B/A) TOTAL RENAL CARE INC
  • Facility Address: 5060 S STATE ST
    CHICAGO, IL
    ZIP 60609
  • Facility Phone: 773 702-3399
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: MARY S. HAMMES MD
  • NPI Number: 1447565072
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2014077
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name WOODLAWN DIALYSIS (D/B/A) TOTAL RENAL CARE INC
Street 5060 S STATE ST
City CHICAGO
State IL
ZIP 60609
Phone 773 702-3399
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/30/2024
Certificate Expiration Date 9/29/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director MARY S. HAMMES MD

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