14D2023960 CLIA NUMBER - GRAND CROSSING DIALYSIS TOTAL RENAL CARE INC

Laboratory Demographics

  • CLIA Code: 14D2023960
  • Facility Name: GRAND CROSSING DIALYSIS TOTAL RENAL CARE INC
  • Facility Address: 7319 S COTTAGE GROVE AVE
    CHICAGO, IL
    ZIP 60619
  • Facility Phone: (773) 783-3491
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: MOHAMED SALEM
  • NPI Number: 1730488214
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2023960
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name GRAND CROSSING DIALYSIS TOTAL RENAL CARE INC
Street 7319 S COTTAGE GROVE AVE
City CHICAGO
State IL
ZIP 60619
Phone 7737833491
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/5/2025
Certificate Expiration Date 5/4/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director MOHAMED SALEM

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This page was last updated on: 5/18/2026