14D2196556 CLIA NUMBER - CONCORD PLACE

Laboratory Demographics

  • CLIA Code: 14D2196556
  • Facility Name: CONCORD PLACE
  • Facility Address: 401 WEST LAKE ST
    NORTHLAKE, IL
    ZIP 60164
  • Facility Phone: 708 562-9000
  • Facility Type: Other - SUPPORTIVE LIVING
  • Facility Type: Waiver
  • Lab Director: DAVID POKORNY
  • NPI Number: 1053586552
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 14D2196556
LAB Type Other - SUPPORTIVE LIVING
Facility Name CONCORD PLACE
Street 401 WEST LAKE ST
City NORTHLAKE
State IL
ZIP 60164
Phone 708 562-9000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/19/2024
Certificate Expiration Date 10/18/2026
Facility Type Other - SUPPORTIVE LIVING
Lab Director DAVID POKORNY

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