14D2130588 CLIA NUMBER - ROBERT H LURIE COMPREHENSIVE CANCER CTR

Laboratory Demographics

  • CLIA Code: 14D2130588
  • Facility Name: ROBERT H LURIE COMPREHENSIVE CANCER CTR
  • Facility Address: 675 N SAINT CLAIR ST, SUITE 21-100
    CHICAGO, IL
    ZIP 60611
  • Facility Phone: 312 695-2512
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MARY MULCAHY
  • NPI Number: 1770761876
  • Taxonomy: 207RR0500X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2130588
LAB Type Physician Office
Facility Name ROBERT H LURIE COMPREHENSIVE CANCER CTR
Street 675 N SAINT CLAIR ST, SUITE 21-100
City CHICAGO
State IL
ZIP 60611
Phone 312 695-2512
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 6/15/2024
Certificate Expiration Date 6/14/2026
Facility Type Physician Office
Lab Director MARY MULCAHY

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