14D2086498 CLIA NUMBER - YOUTH OUTREACH SERVICES

Laboratory Demographics

  • CLIA Code: 14D2086498
  • Facility Name: YOUTH OUTREACH SERVICES
  • Facility Address: 6417 W IRVING PARK RD
    CHICAGO, IL
    ZIP 60634
  • Facility Phone: 773 777-7112
  • Facility Type: Other - OUTPT SUBSTANCE ABUSE TRM
  • Facility Type: Waiver
  • Lab Director: RICK VELASQUEZ
  • NPI Number: 1568916476
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 14D2086498
LAB Type Other - OUTPT SUBSTANCE ABUSE TRM
Facility Name YOUTH OUTREACH SERVICES
Street 6417 W IRVING PARK RD
City CHICAGO
State IL
ZIP 60634
Phone 773 777-7112
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/5/2024
Certificate Expiration Date 11/4/2026
Facility Type Other - OUTPT SUBSTANCE ABUSE TRM
Lab Director RICK VELASQUEZ

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