14D2065347 CLIA NUMBER - VILLAGE DOCTOR LTD

Laboratory Demographics

  • CLIA Code: 14D2065347
  • Facility Name: VILLAGE DOCTOR LTD
  • Facility Address: 2323 W CHICAGO AVE
    CHICAGO, IL
    ZIP 60622
  • Facility Phone: 773 276-8600
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: IOURI MELNIK
  • NPI Number: 1982814992
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2065347
LAB Type Physician Office
Facility Name VILLAGE DOCTOR LTD
Street 2323 W CHICAGO AVE
City CHICAGO
State IL
ZIP 60622
Phone 773 276-8600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/9/2025
Certificate Expiration Date 9/8/2027
Facility Type Physician Office
Lab Director IOURI MELNIK

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