14D2133907 CLIA NUMBER - DIALYSIS CARE CENTER OLYMPIA FIELDS L L C

Laboratory Demographics

CLIA Number: 14D2133907

Facility Name: DIALYSIS CARE CENTER OLYMPIA FIELDS L L C

Facility Address:
3322 VOLLMER RD, SUITE C
OLYMPIA FIELDS, IL
ZIP 60461
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Facility Phone Number: 708 964-2250

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1003368440

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D2133907
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	DIALYSIS CARE CENTER OLYMPIA FIELDS L L C
Street	3322 VOLLMER RD, SUITE C
City	OLYMPIA FIELDS
State	IL
ZIP	60461
Phone	708 964-2250
CertificateType	4
CertificateEffectiveDate	7/21/2023
CertificateExpirationDate	7/20/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024