14D2100335 CLIA NUMBER - ALSIP HOME TRAINING

Laboratory Demographics

  • CLIA Code: 14D2100335
  • Facility Name: ALSIP HOME TRAINING
  • Facility Address: 11500 S PULASKI RD
    ALSIP, IL
    ZIP 60803
  • Facility Phone: 708 385-7145
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: MOHAMAD BARAKAT MD
  • NPI Number: 1720461742
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2100335
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name ALSIP HOME TRAINING
Street 11500 S PULASKI RD
City ALSIP
State IL
ZIP 60803
Phone 708 385-7145
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/12/2025
Certificate Expiration Date 8/11/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director MOHAMAD BARAKAT MD

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