14D2146857 CLIA NUMBER - PREFERRED URGENT CARE L L C

Laboratory Demographics

CLIA Number: 14D2146857

Facility Name: PREFERRED URGENT CARE L L C

Facility Address:
4849 W FULLERTON AVE
CHICAGO, IL
ZIP 60639
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Facility Phone Number: 773 309-6740

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1881181055

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D2146857
LAB Type	Physician Office
Facility Name	PREFERRED URGENT CARE L L C
Street	4849 W FULLERTON AVE
City	CHICAGO
State	IL
ZIP	60639
Phone	773 309-6740
CertificateType	4
CertificateEffectiveDate	4/6/2024
CertificateExpirationDate	4/5/2026
FacilityType	Waiver

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