14D2109504 CLIA NUMBER - PATRICK GALLAGHER MD SC

Laboratory Demographics

  • CLIA Code: 14D2109504
  • Facility Name: PATRICK GALLAGHER MD SC
  • Facility Address: 211 E CHICAGO AVE, #1700
    CHICAGO, IL
    ZIP 60611
  • Facility Phone: 312 995-8961
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PATRICK GALLAGHER MD
  • NPI Number: 1639554793
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2109504
LAB Type Physician Office
Facility Name PATRICK GALLAGHER MD SC
Street 211 E CHICAGO AVE, #1700
City CHICAGO
State IL
ZIP 60611
Phone 312 995-8961
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/26/2024
Certificate Expiration Date 2/25/2026
Facility Type Physician Office
Lab Director PATRICK GALLAGHER MD

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