14D2093383 CLIA NUMBER - CHICAGO RIDGE DIALYSIS

Laboratory Demographics

  • CLIA Code: 14D2093383
  • Facility Name: CHICAGO RIDGE DIALYSIS
  • Facility Address: 10511 S HARLEM AVE
    CHICAGO RIDGE, IL
    ZIP 60415
  • Facility Phone: 708 361-2863
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: SREYA PALLATH
  • NPI Number: 1629466339
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2093383
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name CHICAGO RIDGE DIALYSIS
Street 10511 S HARLEM AVE
City CHICAGO RIDGE
State IL
ZIP 60415
Phone 708 361-2863
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/25/2025
Certificate Expiration Date 3/24/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director SREYA PALLATH

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