14D2182481 CLIA NUMBER - PRAIRIE GREEN AT DIXIE CROSSING

Laboratory Demographics

  • CLIA Code: 14D2182481
  • Facility Name: PRAIRIE GREEN AT DIXIE CROSSING
  • Facility Address: 1040 DIXIE HIGHWAY
    CHICAGO HEIGHTS, IL
    ZIP 60411
  • Facility Phone: 708 754-5400
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: VINCENT WHITE
  • NPI Number: 1831531805
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 14D2182481
LAB Type Assisted Living Facility
Facility Name PRAIRIE GREEN AT DIXIE CROSSING
Street 1040 DIXIE HIGHWAY
City CHICAGO HEIGHTS
State IL
ZIP 60411
Phone 708 754-5400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/22/2024
Certificate Expiration Date 4/21/2026
Facility Type Assisted Living Facility
Lab Director VINCENT WHITE

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