14D2115170 CLIA NUMBER - ADVOCATE MED GROUP ACC CHICAGO, 95TH ST

Laboratory Demographics

  • CLIA Code: 14D2115170
  • Facility Name: ADVOCATE MED GROUP ACC CHICAGO, 95TH ST
  • Facility Address: 2210 WEST 95TH ST
    CHICAGO, IL
    ZIP 60643
  • Facility Phone: 773 295-3101
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JEROME DALY DO
  • NPI Number: 1972959054
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2115170
LAB Type Physician Office
Facility Name ADVOCATE MED GROUP ACC CHICAGO, 95TH ST
Street 2210 WEST 95TH ST
City CHICAGO
State IL
ZIP 60643
Phone 773 295-3101
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/29/2024
Certificate Expiration Date 6/28/2026
Facility Type Physician Office
Lab Director JEROME DALY DO

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