14D2150652 CLIA NUMBER - WICKER PARK IMMEDIATE CARE L L C

Laboratory Demographics

  • CLIA Code: 14D2150652
  • Facility Name: WICKER PARK IMMEDIATE CARE L L C
  • Facility Address: 1601 W DIVISION ST CLINIC STORE FRONT
    CHICAGO, IL
    ZIP 60622
  • Facility Phone: 773 227-3669
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ABHIJIT A. SHINDE M D PHD
  • NPI Number: 1619620853
  • Taxonomy: 251S00000X - Community/Behavioral Health

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D2150652
LAB Type Physician Office
Facility Name WICKER PARK IMMEDIATE CARE L L C
Street 1601 W DIVISION ST CLINIC STORE FRONT
City CHICAGO
State IL
ZIP 60622
Phone 773 227-3669
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/29/2024
Certificate Expiration Date 6/28/2026
Facility Type Physician Office
Lab Director ABHIJIT A. SHINDE M D PHD

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