14D2175138 CLIA NUMBER - EWA HAMPSTON M D

Laboratory Demographics

  • CLIA Code: 14D2175138
  • Facility Name: EWA HAMPSTON M D
  • Facility Address: 12130 S HARLEM AVE - STE B
    PALOS HEIGHTS, IL
    ZIP 60463
  • Facility Phone: 708 448-5500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EWA V. HAMPSTON M D
  • NPI Number: 1770694200
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2175138
LAB Type Physician Office
Facility Name EWA HAMPSTON M D
Street 12130 S HARLEM AVE - STE B
City PALOS HEIGHTS
State IL
ZIP 60463
Phone 708 448-5500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/18/2023
Certificate Expiration Date 11/17/2025
Facility Type Physician Office
Lab Director EWA V. HAMPSTON M D

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