14D2149689 CLIA NUMBER - RUTH ROTHSTEIN CORE CENTER

Laboratory Demographics

  • CLIA Code: 14D2149689
  • Facility Name: RUTH ROTHSTEIN CORE CENTER
  • Facility Address: 2020 W HARRISON ST
    CHICAGO, IL
    ZIP 60612
  • Facility Phone: 312 572-4507
  • Facility Type: Other - HIV TESTING & COMMUNITY
  • Facility Type: Microscopy
  • Lab Director: MONICA MERCON
  • NPI Number: 1861513996
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2149689
LAB Type Other - HIV TESTING & COMMUNITY
Facility Name RUTH ROTHSTEIN CORE CENTER
Street 2020 W HARRISON ST
City CHICAGO
State IL
ZIP 60612
Phone 312 572-4507
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 6/8/2024
Certificate Expiration Date 6/7/2026
Facility Type Other - HIV TESTING & COMMUNITY
Lab Director MONICA MERCON

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