14D2208896 CLIA NUMBER - ESPERANZA HEALTH CENTERS

Laboratory Demographics

  • CLIA Code: 14D2208896
  • Facility Name: ESPERANZA HEALTH CENTERS
  • Facility Address: 3124 W 59TH ST
    CHICAGO, IL
    ZIP 60629
  • Facility Phone: 773 584-6132
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: DANIEL C. FULWILER
  • NPI Number: 1124187125
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2208896
LAB Type Federally Qualified Health Center
Facility Name ESPERANZA HEALTH CENTERS
Street 3124 W 59TH ST
City CHICAGO
State IL
ZIP 60629
Phone 773 584-6132
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/8/2025
Certificate Expiration Date 1/7/2027
Facility Type Federally Qualified Health Center
Lab Director DANIEL C. FULWILER

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