14D2195809 CLIA NUMBER - MIDWEST ORTHOPAEDICS AT RUSH, L L C

Laboratory Demographics

  • CLIA Code: 14D2195809
  • Facility Name: MIDWEST ORTHOPAEDICS AT RUSH, L L C
  • Facility Address: 1611 W HARRISON ST - STE 212
    CHICAGO, IL
    ZIP 60612
  • Facility Phone: 708 236-7227
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BRIAN COLE M D
  • NPI Number: 1356678619
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 14D2195809
LAB Type Physician Office
Facility Name MIDWEST ORTHOPAEDICS AT RUSH, L L C
Street 1611 W HARRISON ST - STE 212
City CHICAGO
State IL
ZIP 60612
Phone 708 236-7227
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/13/2024
Certificate Expiration Date 10/12/2026
Facility Type Physician Office
Lab Director BRIAN COLE M D

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This page was last updated on: 6/4/2025