14D2144918 CLIA NUMBER - CHICAGO PAIN MEDICINE CENTER

Laboratory Demographics

  • CLIA Code: 14D2144918
  • Facility Name: CHICAGO PAIN MEDICINE CENTER
  • Facility Address: 6307 S STEWART - STE 205
    CHICAGO, IL
    ZIP 60621
  • Facility Phone: 773 868-6824
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAMES R. DIESFELD M D
  • NPI Number: 1871190827
  • Taxonomy: 208VP0014X - Pain Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2144918
LAB Type Physician Office
Facility Name CHICAGO PAIN MEDICINE CENTER
Street 6307 S STEWART - STE 205
City CHICAGO
State IL
ZIP 60621
Phone 773 868-6824
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/19/2024
Certificate Expiration Date 10/18/2026
Facility Type Physician Office
Lab Director JAMES R. DIESFELD M D

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