14D2171613 CLIA NUMBER - BLOOD RUN EXPRESS LLC

Laboratory Demographics

CLIA Number: 14D2171613

Facility Name: BLOOD RUN EXPRESS LLC

Facility Address:
581 BURLINGTON AVE - STE 5
CLARENDON HILLS, IL
ZIP 60514
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Facility Phone Number: 630 888-5640

Facility Type: Mobile Laboratory

Certificate Type: Waiver

NPI Number: 1508491036

Taxonomy: 246RP1900X - Technician, Pathology

CLIA Record

Field Name	Field Value
CLIA Number	14D2171613
LAB Type	Mobile Laboratory
Facility Name	BLOOD RUN EXPRESS LLC
Street	581 BURLINGTON AVE - STE 5
City	CLARENDON HILLS
State	IL
ZIP	60514
Phone	630 888-5640
CertificateType	4
CertificateEffectiveDate	9/5/2023
CertificateExpirationDate	9/4/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024