14D2074682 CLIA NUMBER - WEST SIDE DIALYSIS

Laboratory Demographics

  • CLIA Code: 14D2074682
  • Facility Name: WEST SIDE DIALYSIS
  • Facility Address: 1600 WEST 13TH ST
    CHICAGO, IL
    ZIP 60608
  • Facility Phone: 312 243-9286
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DON L. HOLLANDSWORTH
  • NPI Number: 1174947204
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2074682
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name WEST SIDE DIALYSIS
Street 1600 WEST 13TH ST
City CHICAGO
State IL
ZIP 60608
Phone 312 243-9286
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/13/2024
Certificate Expiration Date 3/12/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DON L. HOLLANDSWORTH

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