14D2148684 CLIA NUMBER - GRAND PRAIRIE SERVICES WHOLE HEALTH & WELLNESS

Laboratory Demographics

  • CLIA Code: 14D2148684
  • Facility Name: GRAND PRAIRIE SERVICES WHOLE HEALTH & WELLNESS
  • Facility Address: 450 W 14TH ST
    CHICAGO HEIGHTS, IL
    ZIP 60411
  • Facility Phone: 708 985-3040
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LAMBROS CHRONES M D
  • NPI Number: 1487109864
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2148684
LAB Type Physician Office
Facility Name GRAND PRAIRIE SERVICES WHOLE HEALTH & WELLNESS
Street 450 W 14TH ST
City CHICAGO HEIGHTS
State IL
ZIP 60411
Phone 708 985-3040
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/16/2024
Certificate Expiration Date 5/15/2026
Facility Type Physician Office
Lab Director LAMBROS CHRONES M D

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