14D2118588 CLIA NUMBER - MICHAEL MICHELINI CENTER FOR HEALTH

Laboratory Demographics

  • CLIA Code: 14D2118588
  • Facility Name: MICHAEL MICHELINI CENTER FOR HEALTH
  • Facility Address: 1431 N WESTERN AVE, STE 209
    CHICAGO, IL
    ZIP 60622
  • Facility Phone: 312 770-2040
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: JIM CHRISTOFORIDIS MD
  • NPI Number: 1326219494
  • Taxonomy: 213ES0103X - Podiatrist

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D2118588
LAB Type Federally Qualified Health Center
Facility Name MICHAEL MICHELINI CENTER FOR HEALTH
Street 1431 N WESTERN AVE, STE 209
City CHICAGO
State IL
ZIP 60622
Phone 312 770-2040
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 9/12/2024
Certificate Expiration Date 9/11/2026
Facility Type Federally Qualified Health Center
Lab Director JIM CHRISTOFORIDIS MD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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