14D2021376 CLIA NUMBER - GARFIELD COUNSELING CENTER INC

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Laboratory Demographics

CLIA Number: 14D2021376

Facility Name: GARFIELD COUNSELING CENTER INC

Facility Address:
4132 W MADISON ST
CHICAGO, IL
ZIP 60624
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Facility Phone Number: 773 533-0433

Facility Type: Comp. Outpatient Rehab Facility

Certificate Type: Waiver

NPI Number: 1124206032

Taxonomy: 261QR0405X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D2021376
LAB Type	Comp. Outpatient Rehab Facility
Facility Name	GARFIELD COUNSELING CENTER INC
Street	4132 W MADISON ST
City	CHICAGO
State	IL
ZIP	60624
Phone	773 533-0433
CertificateType	4
CertificateEffectiveDate	3/11/2023
CertificateExpirationDate	3/10/2025
FacilityType	Waiver

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