14D2015856 CLIA NUMBER - MRI OF RIVER NORTH

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Laboratory Demographics

CLIA Number: 14D2015856

Facility Name: MRI OF RIVER NORTH

Facility Address:
559 W KINZIE ST
CHICAGO, IL
ZIP 60654
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Facility Phone Number: 972 842-9020

Facility Type: Other - DIAGNOSTIC IMAGING

Certificate Type: Waiver

NPI Number: 1316949886

Taxonomy: 261QM1200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D2015856
LAB Type	Other - DIAGNOSTIC IMAGING
Facility Name	MRI OF RIVER NORTH
Street	559 W KINZIE ST
City	CHICAGO
State	IL
ZIP	60654
Phone	972 842-9020
CertificateType	4
CertificateEffectiveDate	11/8/2022
CertificateExpirationDate	11/7/2024
FacilityType	Waiver

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