14D2165720 CLIA NUMBER - CASE INTEGRATIVE HEALTH WELLSMITH PLCC

Laboratory Demographics

  • CLIA Code: 14D2165720
  • Facility Name: CASE INTEGRATIVE HEALTH WELLSMITH PLCC
  • Facility Address: 1732 W HUBBARD - STE 24
    CHICAGO, IL
    ZIP 60622
  • Facility Phone: 773 675-1400
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CASEY S. KELLEY M D
  • NPI Number: 1477012458
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2165720
LAB Type Physician Office
Facility Name CASE INTEGRATIVE HEALTH WELLSMITH PLCC
Street 1732 W HUBBARD - STE 24
City CHICAGO
State IL
ZIP 60622
Phone 773 675-1400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/3/2025
Certificate Expiration Date 5/2/2027
Facility Type Physician Office
Lab Director CASEY S. KELLEY M D

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