14D2120201 CLIA NUMBER - BROOKDALE LAKE SHORE DRIVE

Laboratory Demographics

  • CLIA Code: 14D2120201
  • Facility Name: BROOKDALE LAKE SHORE DRIVE
  • Facility Address: 2960 NORTH LAKE SHORE DR
    CHICAGO, IL
    ZIP 60657
  • Facility Phone: 773 880-2960
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: ERIKA KEEGAN
  • NPI Number: 1447539416
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 14D2120201
LAB Type Assisted Living Facility
Facility Name BROOKDALE LAKE SHORE DRIVE
Street 2960 NORTH LAKE SHORE DR
City CHICAGO
State IL
ZIP 60657
Phone 773 880-2960
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/12/2024
Certificate Expiration Date 10/11/2026
Facility Type Assisted Living Facility
Lab Director ERIKA KEEGAN

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