14D2157267 CLIA NUMBER - MOUNT SINAI HOSPITAL SPASTICITY CLINIC

Laboratory Demographics

  • CLIA Code: 14D2157267
  • Facility Name: MOUNT SINAI HOSPITAL SPASTICITY CLINIC
  • Facility Address: 1401 S CALIFORNIA AVE - 2ND FLR (CLINIC 2 NORTH)
    CHICAGO, IL
    ZIP 60608
  • Facility Phone: 773 565-3250
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHELLE GITTLER M D
  • NPI Number: 1104858125
  • Taxonomy: 282NR1301X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 14D2157267
LAB Type Physician Office
Facility Name MOUNT SINAI HOSPITAL SPASTICITY CLINIC
Street 1401 S CALIFORNIA AVE - 2ND FLR (CLINIC 2 NORTH)
City CHICAGO
State IL
ZIP 60608
Phone 773 565-3250
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/2/2024
Certificate Expiration Date 11/1/2026
Facility Type Physician Office
Lab Director MICHELLE GITTLER M D

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