14D2145779 CLIA NUMBER - HISPANIC MEDICAL SERVICES S C

Laboratory Demographics

CLIA Number: 14D2145779

Facility Name: HISPANIC MEDICAL SERVICES S C

Facility Address:
5544 W BELMONT AVE
CHICAGO, IL
ZIP 60641
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Facility Phone Number: (773) 685-7816

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1659449718

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D2145779
LAB Type	PHYSICIAN OFFICE
Facility Name	HISPANIC MEDICAL SERVICES S C
Street	5544 W BELMONT AVE
City	CHICAGO
State	IL
ZIP	60641
Phone	(773) 685-7816

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This page was last updated on: 5/11/2023