14D2020657 CLIA NUMBER - AUBURN GRESHAM CBOC

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Laboratory Demographics

CLIA Number: 14D2020657

Facility Name: AUBURN GRESHAM CBOC

Facility Address:
7731 SOUTH HALSTED
CHICAGO, IL
ZIP 60620
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Facility Phone Number: 312 963-3700

Facility Type: Community Clinic

Certificate Type: Accreditation

NPI Number: 1548438450

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	14D2020657
LAB Type	Community Clinic
Facility Name	AUBURN GRESHAM CBOC
Street	7731 SOUTH HALSTED
City	CHICAGO
State	IL
ZIP	60620
Phone	312 963-3700
CertificateType	1
CertificateEffectiveDate	2/24/2011
CertificateExpirationDate	5/22/2026
FacilityType	Accreditation

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