14D2211002 CLIA NUMBER - QUEST DIAGNOSTICS - FULLERTON HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 14D2211002
  • Facility Name: QUEST DIAGNOSTICS - FULLERTON HEALTH CENTER
  • Facility Address: 3924 W FULLERTON AVE - LAB ROOM
    CHICAGO, IL
    ZIP 60647
  • Facility Phone: 773 276-2229
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: MATTHEW KRAIZA
  • NPI Number: 1083205942
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 14D2211002
LAB Type Independent
Facility Name QUEST DIAGNOSTICS - FULLERTON HEALTH CENTER
Street 3924 W FULLERTON AVE - LAB ROOM
City CHICAGO
State IL
ZIP 60647
Phone 773 276-2229
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/25/2025
Certificate Expiration Date 1/24/2027
Facility Type Independent
Lab Director MATTHEW KRAIZA

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