14D2213204 CLIA NUMBER - JENCARE SENIOR MEDICAL CENTER-DOLTON

Laboratory Demographics

  • CLIA Code: 14D2213204
  • Facility Name: JENCARE SENIOR MEDICAL CENTER-DOLTON
  • Facility Address: 600-618 EAST SIBLEY BLVD
    DOLTON, IL
    ZIP 60419
  • Facility Phone: (305) 842-3910
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GORDON CHEN
  • NPI Number: 1013520113
  • Taxonomy: 332900000X - Non-Pharmacy Dispensing Site

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CLIA Record

Field Name Field Value
CLIA Number 14D2213204
LAB Type Physician Office
Facility Name JENCARE SENIOR MEDICAL CENTER-DOLTON
Street 600-618 EAST SIBLEY BLVD
City DOLTON
State IL
ZIP 60419
Phone 3058423910
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/10/2025
Certificate Expiration Date 2/9/2027
Facility Type Physician Office
Lab Director GORDON CHEN

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This page was last updated on: 5/18/2026