14D2110672 CLIA NUMBER - INNER CITY MUSLIM ACTION NETWORK

Laboratory Demographics

  • CLIA Code: 14D2110672
  • Facility Name: INNER CITY MUSLIM ACTION NETWORK
  • Facility Address: 2744 W 63RD ST
    CHICAGO, IL
    ZIP 60629
  • Facility Phone: 773 434-4626
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: BRITTANI JAMES
  • NPI Number: 1437672433
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2110672
LAB Type Community Clinic
Facility Name INNER CITY MUSLIM ACTION NETWORK
Street 2744 W 63RD ST
City CHICAGO
State IL
ZIP 60629
Phone 773 434-4626
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2024
Certificate Expiration Date 3/21/2026
Facility Type Community Clinic
Lab Director BRITTANI JAMES

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