14D2168344 CLIA NUMBER - MOBILE CARE CHICAGO

Laboratory Demographics

  • CLIA Code: 14D2168344
  • Facility Name: MOBILE CARE CHICAGO
  • Facility Address: 321 N LOOMIS
    CHICAGO, IL
    ZIP 60607
  • Facility Phone: 773 254-4030
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: PAUL F. DETJEN M D
  • NPI Number: 1265502728
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 14D2168344
LAB Type Mobile Laboratory
Facility Name MOBILE CARE CHICAGO
Street 321 N LOOMIS
City CHICAGO
State IL
ZIP 60607
Phone 773 254-4030
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/26/2025
Certificate Expiration Date 6/25/2027
Facility Type Mobile Laboratory
Lab Director PAUL F. DETJEN M D

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