14D2127479 CLIA NUMBER - UNIVERSITY OF CHICAGO MEDICINE SOUTH LOOP CLINIC

Laboratory Demographics

  • CLIA Code: 14D2127479
  • Facility Name: UNIVERSITY OF CHICAGO MEDICINE SOUTH LOOP CLINIC
  • Facility Address: 1101 S CANAL ST, SUITE 201
    CHICAGO, IL
    ZIP 60607
  • Facility Phone: 773 702-1013
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JENNIFER ANGELES
  • NPI Number: 1447390125
  • Taxonomy: 3336C0002X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2127479
LAB Type Physician Office
Facility Name UNIVERSITY OF CHICAGO MEDICINE SOUTH LOOP CLINIC
Street 1101 S CANAL ST, SUITE 201
City CHICAGO
State IL
ZIP 60607
Phone 773 702-1013
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 3/14/2025
Certificate Expiration Date 3/13/2027
Facility Type Physician Office
Lab Director JENNIFER ANGELES

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This page was last updated on: 6/4/2025