14D2203791 CLIA NUMBER - AVENUES TO INDEPENDENCE

Laboratory Demographics

CLIA Code: 14D2203791
Facility Name: AVENUES TO INDEPENDENCE
Facility Address: 100 N CLIFTON AVE
PARK RIDGE, IL
ZIP 60068
Facility Phone: 847 825-6498
Facility Type: Other - GROUP HOME INTELLECT DIS
Facility Type: Waiver
Lab Director: STEPHEN G. KRAY
NPI Number: 1215250881
Taxonomy: 320900000X - Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

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CLIA Record

Field Name	Field Value
CLIA Number	14D2203791
LAB Type	Other - GROUP HOME INTELLECT DIS
Facility Name	AVENUES TO INDEPENDENCE
Street	100 N CLIFTON AVE
City	PARK RIDGE
State	IL
ZIP	60068
Phone	847 825-6498
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	12/6/2024
Certificate Expiration Date	12/5/2026
Facility Type	Other - GROUP HOME INTELLECT DIS
Lab Director	STEPHEN G. KRAY

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