14D2069056 CLIA NUMBER - KIDNEY CARE CENTER ELGIN L L C

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Laboratory Demographics

CLIA Number: 14D2069056

Facility Name: KIDNEY CARE CENTER ELGIN L L C

Facility Address:
1750 N RANDALL RD
ELGIN, IL
ZIP 60123
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Facility Phone Number: 224 238-3211

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1508126764

Taxonomy: 207RN0300X - Internal Medicine
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

CLIA Record

Field Name	Field Value
CLIA Number	14D2069056
LAB Type	Physician Office
Facility Name	KIDNEY CARE CENTER ELGIN L L C
Street	1750 N RANDALL RD
City	ELGIN
State	IL
ZIP	60123
Phone	224 238-3211
CertificateType	4
CertificateEffectiveDate	11/18/2023
CertificateExpirationDate	11/17/2025
FacilityType	Waiver

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