14D2071610 CLIA NUMBER - PCC COMMUNITY WELLNESS CTR - WEST SUBURBAN

Laboratory Demographics

  • CLIA Code: 14D2071610
  • Facility Name: PCC COMMUNITY WELLNESS CTR - WEST SUBURBAN
  • Facility Address: 1 ERIE COURT - STE 7120
    OAK PARK, IL
    ZIP 60302
  • Facility Phone: 773 537-0020
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: DINA V. ZISSIMOPOULOS
  • NPI Number: 1508287673
  • Taxonomy: 261QF0400X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D2071610
LAB Type Federally Qualified Health Center
Facility Name PCC COMMUNITY WELLNESS CTR - WEST SUBURBAN
Street 1 ERIE COURT - STE 7120
City OAK PARK
State IL
ZIP 60302
Phone 773 537-0020
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/26/2024
Certificate Expiration Date 9/25/2026
Facility Type Federally Qualified Health Center
Lab Director DINA V. ZISSIMOPOULOS

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