14D2062024 CLIA NUMBER - ESPERANZA HEALTH CENTERS

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Laboratory Demographics

CLIA Number: 14D2062024

Facility Name: ESPERANZA HEALTH CENTERS

Facility Address:
6550 S RICHMOND ST
CHICAGO, IL
ZIP 60629
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Facility Phone Number: 773 584-6132

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy

NPI Number: 1124187125

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D2062024
LAB Type	Federally Qualified Health Center
Facility Name	ESPERANZA HEALTH CENTERS
Street	6550 S RICHMOND ST
City	CHICAGO
State	IL
ZIP	60629
Phone	773 584-6132
CertificateType	3
CertificateEffectiveDate	9/2/2023
CertificateExpirationDate	9/1/2025
FacilityType	PPMP

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