14D2195453 CLIA NUMBER - SUNRISE OF PALOS PARK

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Laboratory Demographics

CLIA Number: 14D2195453

Facility Name: SUNRISE OF PALOS PARK

Facility Address:
12828 S LAGRANGE RD
PALOS PARK, IL
ZIP 60464
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Facility Phone Number: 708 361-3577

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1396947826

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	14D2195453
LAB Type	Assisted Living Facility
Facility Name	SUNRISE OF PALOS PARK
Street	12828 S LAGRANGE RD
City	PALOS PARK
State	IL
ZIP	60464
Phone	708 361-3577
CertificateType	4
CertificateEffectiveDate	10/8/2022
CertificateExpirationDate	10/7/2024
FacilityType	Waiver

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