14D2063789 CLIA NUMBER - BELMONT EYE CARE

Laboratory Demographics

  • CLIA Code: 14D2063789
  • Facility Name: BELMONT EYE CARE
  • Facility Address: 3110 W BELMONT, STE 1-E
    CHICAGO, IL
    ZIP 60618
  • Facility Phone: 312 626-2376
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GOLIE ROSHANDEL KEOVAN
  • NPI Number: 1669888947
  • Taxonomy: 122300000X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 14D2063789
LAB Type Physician Office
Facility Name BELMONT EYE CARE
Street 3110 W BELMONT, STE 1-E
City CHICAGO
State IL
ZIP 60618
Phone 312 626-2376
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/8/2025
Certificate Expiration Date 8/7/2027
Facility Type Physician Office
Lab Director GOLIE ROSHANDEL KEOVAN

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