14D2077690 CLIA NUMBER - MILTON C CHAVEZ

Laboratory Demographics

  • CLIA Code: 14D2077690
  • Facility Name: MILTON C CHAVEZ
  • Facility Address: 1509 N WESTERN AVE
    CHICAGO, IL
    ZIP 60622
  • Facility Phone: 773 227-3303
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MILTON CHAVEZ
  • NPI Number: 1700869450
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2077690
LAB Type Physician Office
Facility Name MILTON C CHAVEZ
Street 1509 N WESTERN AVE
City CHICAGO
State IL
ZIP 60622
Phone 773 227-3303
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/13/2024
Certificate Expiration Date 5/12/2026
Facility Type Physician Office
Lab Director MILTON CHAVEZ

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