14D2207954 CLIA NUMBER - HUMBOLDT PARK HEALTH

Laboratory Demographics

  • CLIA Code: 14D2207954
  • Facility Name: HUMBOLDT PARK HEALTH
  • Facility Address: 1044 N FRANCISCO AVE
    CHICAGO, IL
    ZIP 60622
  • Facility Phone: 773 292-4236
  • Facility Type: Hospital
  • Facility Type: Waiver
  • Lab Director: DAGOBERTO CAMACHO
  • NPI Number: 1740417153
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2207954
LAB Type Hospital
Facility Name HUMBOLDT PARK HEALTH
Street 1044 N FRANCISCO AVE
City CHICAGO
State IL
ZIP 60622
Phone 773 292-4236
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/3/2025
Certificate Expiration Date 1/2/2027
Facility Type Hospital
Lab Director DAGOBERTO CAMACHO

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