14D2104012 CLIA NUMBER - EATING RECOVERY CENTER OF CHICAGO

Laboratory Demographics

  • CLIA Code: 14D2104012
  • Facility Name: EATING RECOVERY CENTER OF CHICAGO
  • Facility Address: 150 E HURON ST, 1200-1300
    CHICAGO, IL
    ZIP 60611
  • Facility Phone: 312 540-9955
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LARA KENIK
  • NPI Number: 1437649266
  • Taxonomy: 323P00000X - Psychiatric Residential Treatment Facility

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CLIA Record

Field Name Field Value
CLIA Number 14D2104012
LAB Type Physician Office
Facility Name EATING RECOVERY CENTER OF CHICAGO
Street 150 E HURON ST, 1200-1300
City CHICAGO
State IL
ZIP 60611
Phone 312 540-9955
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/26/2023
Certificate Expiration Date 10/25/2025
Facility Type Physician Office
Lab Director LARA KENIK

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