14D2150644 CLIA NUMBER - LURIE CHILDREN'S ADOLESCENT MEDICINE

Laboratory Demographics

  • CLIA Code: 14D2150644
  • Facility Name: LURIE CHILDREN'S ADOLESCENT MEDICINE
  • Facility Address: 1440 N DAYTON ST
    CHICAGO, IL
    ZIP 60642
  • Facility Phone: 312 227-3985
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: NITIN R. WADHWANI M D
  • NPI Number: 1134590995
  • Taxonomy: 208000000X - Pediatrics

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D2150644
LAB Type Physician Office
Facility Name LURIE CHILDREN'S ADOLESCENT MEDICINE
Street 1440 N DAYTON ST
City CHICAGO
State IL
ZIP 60642
Phone 312 227-3985
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 6/29/2024
Certificate Expiration Date 6/28/2026
Facility Type Physician Office
Lab Director NITIN R. WADHWANI M D

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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