14D2061183 CLIA NUMBER - PHYSICIANS IMMEDIATE CARE

Laboratory Demographics

  • CLIA Code: 14D2061183
  • Facility Name: PHYSICIANS IMMEDIATE CARE
  • Facility Address: 3909 N WESTERN AVE
    CHICAGO, IL
    ZIP 60618
  • Facility Phone: 773 739-9200
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: ROBERT BIERNBAUM
  • NPI Number: 1982785515
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2061183
LAB Type Practitioner Other
Facility Name PHYSICIANS IMMEDIATE CARE
Street 3909 N WESTERN AVE
City CHICAGO
State IL
ZIP 60618
Phone 773 739-9200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/24/2025
Certificate Expiration Date 6/23/2027
Facility Type Practitioner Other
Lab Director ROBERT BIERNBAUM

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