14D2045421 CLIA NUMBER - PHYSICIANS IMMEDIATE CARE

Laboratory Demographics

  • CLIA Code: 14D2045421
  • Facility Name: PHYSICIANS IMMEDIATE CARE
  • Facility Address: 2077 N CLYBOURN AVE
    CHICAGO, IL
    ZIP 60614
  • Facility Phone: 773 886-1500
  • Facility Type: Other - URGENT CARE
  • Facility Type: Waiver
  • Lab Director: ROBERT BIERNBAUM
  • NPI Number: 1063638674
  • Taxonomy: 111NS0005X - Chiropractor

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CLIA Record

Field Name Field Value
CLIA Number 14D2045421
LAB Type Other - URGENT CARE
Facility Name PHYSICIANS IMMEDIATE CARE
Street 2077 N CLYBOURN AVE
City CHICAGO
State IL
ZIP 60614
Phone 773 886-1500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/13/2024
Certificate Expiration Date 8/12/2026
Facility Type Other - URGENT CARE
Lab Director ROBERT BIERNBAUM

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