14D2197447 CLIA NUMBER - ILLINOIS DEPT OF PUBLIC HEALTH, CHICAGO LAB

Home > CLIA Lookup > 14D2197447

Laboratory Demographics

CLIA Number: 14D2197447

Facility Name: ILLINOIS DEPT OF PUBLIC HEALTH, CHICAGO LAB

Facility Address:
2121 W TAYLOR
CHICAGO, IL
ZIP 60614
Get Directions

Facility Phone Number: 312 793-1715

Facility Type: Public Health Laboratories

Certificate Type: Waiver

NPI Number: 1588283402

Taxonomy: 261QM2500X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

CLIA Record

Field Name	Field Value
CLIA Number	14D2197447
LAB Type	Public Health Laboratories
Facility Name	ILLINOIS DEPT OF PUBLIC HEALTH, CHICAGO LAB
Street	2121 W TAYLOR
City	CHICAGO
State	IL
ZIP	60614
Phone	312 793-1715
CertificateType	4
CertificateEffectiveDate	10/26/2022
CertificateExpirationDate	10/25/2024
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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