14D2147698 CLIA NUMBER - GEORGE N ATIA M D S C

Laboratory Demographics

  • CLIA Code: 14D2147698
  • Facility Name: GEORGE N ATIA M D S C
  • Facility Address: 5744 N BROADWAY ST
    CHICAGO, IL
    ZIP 60660
  • Facility Phone: 312 335-0180
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: GEORGE ATIA M D
  • NPI Number: 1598238529
  • Taxonomy: 101YP2500X - Counselor

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CLIA Record

Field Name Field Value
CLIA Number 14D2147698
LAB Type Ambulatory Surgery Center
Facility Name GEORGE N ATIA M D S C
Street 5744 N BROADWAY ST
City CHICAGO
State IL
ZIP 60660
Phone 312 335-0180
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/24/2024
Certificate Expiration Date 4/23/2026
Facility Type Ambulatory Surgery Center
Lab Director GEORGE ATIA M D

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