14D2063465 CLIA NUMBER - RAVENSWOOD PEDIATRICS

Laboratory Demographics

  • CLIA Code: 14D2063465
  • Facility Name: RAVENSWOOD PEDIATRICS
  • Facility Address: 1945 W WILSON AVE, STE 6116
    CHICAGO, IL
    ZIP 60640
  • Facility Phone: 872 208-6257
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TODD J. OCHS
  • NPI Number: 1366874356
  • Taxonomy: 208000000X - Pediatrics

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D2063465
LAB Type Physician Office
Facility Name RAVENSWOOD PEDIATRICS
Street 1945 W WILSON AVE, STE 6116
City CHICAGO
State IL
ZIP 60640
Phone 872 208-6257
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/2/2025
Certificate Expiration Date 8/1/2027
Facility Type Physician Office
Lab Director TODD J. OCHS

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