14D2062215 CLIA NUMBER - FLOSSMOOR HOME DIALYSIS

Laboratory Demographics

  • CLIA Code: 14D2062215
  • Facility Name: FLOSSMOOR HOME DIALYSIS
  • Facility Address: 19720 GOVERNORS HWY, STE 2
    FLOSSMOOR, IL
    ZIP 60422
  • Facility Phone: 708 799-7239
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: KENNETH N. CLINE
  • NPI Number: 1902248792
  • Taxonomy: 261QE0700X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D2062215
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name FLOSSMOOR HOME DIALYSIS
Street 19720 GOVERNORS HWY, STE 2
City FLOSSMOOR
State IL
ZIP 60422
Phone 708 799-7239
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/12/2025
Certificate Expiration Date 7/11/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director KENNETH N. CLINE

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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