14D2124784 CLIA NUMBER - PHYSICIANS IMMEDIATE CARE

Laboratory Demographics

  • CLIA Code: 14D2124784
  • Facility Name: PHYSICIANS IMMEDIATE CARE
  • Facility Address: 4800 WEST 129TH ST
    ALSIP, IL
    ZIP 60803
  • Facility Phone: 708 377-2169
  • Facility Type: Other - URGENT CARE
  • Facility Type: Waiver
  • Lab Director: ROBERT BIERNBAUM
  • NPI Number: 1205814118
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2124784
LAB Type Other - URGENT CARE
Facility Name PHYSICIANS IMMEDIATE CARE
Street 4800 WEST 129TH ST
City ALSIP
State IL
ZIP 60803
Phone 708 377-2169
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/25/2025
Certificate Expiration Date 1/24/2027
Facility Type Other - URGENT CARE
Lab Director ROBERT BIERNBAUM

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