14D2099054 CLIA NUMBER - NORTHSIDE HOME TRAINING

Laboratory Demographics

  • CLIA Code: 14D2099054
  • Facility Name: NORTHSIDE HOME TRAINING
  • Facility Address: 2550 W ADDISON ST, STE A4
    CHICAGO, IL
    ZIP 60618
  • Facility Phone: 773 281-2217
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: JOHN BALL
  • NPI Number: 1750769832
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2099054
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name NORTHSIDE HOME TRAINING
Street 2550 W ADDISON ST, STE A4
City CHICAGO
State IL
ZIP 60618
Phone 773 281-2217
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/20/2025
Certificate Expiration Date 7/19/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director JOHN BALL

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