14D2115126 CLIA NUMBER - ONE MEDICAL WITH ADVOCATE

Laboratory Demographics

  • CLIA Code: 14D2115126
  • Facility Name: ONE MEDICAL WITH ADVOCATE
  • Facility Address: 415 N LASALLE DR - STE 100 - COMMERICAL
    CHICAGO, IL
    ZIP 60654
  • Facility Phone: 888 663-6331
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: OLIVIA CHILDS
  • NPI Number: 1588382832
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2115126
LAB Type Physician Office
Facility Name ONE MEDICAL WITH ADVOCATE
Street 415 N LASALLE DR - STE 100 - COMMERICAL
City CHICAGO
State IL
ZIP 60654
Phone 888 663-6331
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 6/28/2024
Certificate Expiration Date 6/27/2026
Facility Type Physician Office
Lab Director OLIVIA CHILDS

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