14D2099338 CLIA NUMBER - MEDICAL DISTRICT HOME DIALYSIS

Laboratory Demographics

  • CLIA Code: 14D2099338
  • Facility Name: MEDICAL DISTRICT HOME DIALYSIS
  • Facility Address: 1111 S WESTERN AVE
    CHICAGO, IL
    ZIP 60612
  • Facility Phone: 773 521-8371
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: ANDRES SERRANO
  • NPI Number: 1316351232
  • Taxonomy: 2085R0204X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 14D2099338
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name MEDICAL DISTRICT HOME DIALYSIS
Street 1111 S WESTERN AVE
City CHICAGO
State IL
ZIP 60612
Phone 773 521-8371
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/15/2023
Certificate Expiration Date 12/14/2025
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director ANDRES SERRANO

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