14D2108692 CLIA NUMBER - HOME DIALYSIS SERVICES BEVERLY, L L C RENAL CARE PROVIDERS

Laboratory Demographics

  • CLIA Code: 14D2108692
  • Facility Name: HOME DIALYSIS SERVICES BEVERLY, L L C RENAL CARE PROVIDERS
  • Facility Address: 10801 S WESTERN AVE - STE 101
    CHICAGO, IL
    ZIP 60643
  • Facility Phone: 708 645-1000
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: HANI AL-SHARIF
  • NPI Number: 1891066833
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2108692
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name HOME DIALYSIS SERVICES BEVERLY, L L C RENAL CARE PROVIDERS
Street 10801 S WESTERN AVE - STE 101
City CHICAGO
State IL
ZIP 60643
Phone 708 645-1000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/9/2024
Certificate Expiration Date 2/8/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director HANI AL-SHARIF

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