14D2187979 CLIA NUMBER - PHYSICIANS IMMEDIATE CARE

Laboratory Demographics

  • CLIA Code: 14D2187979
  • Facility Name: PHYSICIANS IMMEDIATE CARE
  • Facility Address: 5300 LONG AVE
    CHICAGO, IL
    ZIP 60638
  • Facility Phone: 312 300-7400
  • Facility Type: Other - URGENT CARE
  • Facility Type: Waiver
  • Lab Director: ROBERT BIERNBAUM
  • NPI Number: 1154411072
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2187979
LAB Type Other - URGENT CARE
Facility Name PHYSICIANS IMMEDIATE CARE
Street 5300 LONG AVE
City CHICAGO
State IL
ZIP 60638
Phone 312 300-7400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/10/2024
Certificate Expiration Date 7/9/2026
Facility Type Other - URGENT CARE
Lab Director ROBERT BIERNBAUM

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