14D2147798 CLIA NUMBER - RUSH AMBULATORY BEHAVIORAL HEALTH

Laboratory Demographics

  • CLIA Code: 14D2147798
  • Facility Name: RUSH AMBULATORY BEHAVIORAL HEALTH
  • Facility Address: 2150 W HARRISON ST - BSMT - STE 007 ATTN FRANCES PEREZ
    CHICAGO, IL
    ZIP 60612
  • Facility Phone: 312 942-5375
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SENADA BAJMAKOVIC-KACILA MD
  • NPI Number: 1437344207
  • Taxonomy: 103T00000X - Psychologist

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CLIA Record

Field Name Field Value
CLIA Number 14D2147798
LAB Type Physician Office
Facility Name RUSH AMBULATORY BEHAVIORAL HEALTH
Street 2150 W HARRISON ST - BSMT - STE 007 ATTN FRANCES PEREZ
City CHICAGO
State IL
ZIP 60612
Phone 312 942-5375
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/26/2024
Certificate Expiration Date 4/25/2026
Facility Type Physician Office
Lab Director SENADA BAJMAKOVIC-KACILA MD

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