14D2217103 CLIA NUMBER - DIVISION OF DERMATOLOGY - COOK COUNTY

Laboratory Demographics

  • CLIA Code: 14D2217103
  • Facility Name: DIVISION OF DERMATOLOGY - COOK COUNTY
  • Facility Address: 1950 W POLK ST, SUITE 4407
    CHICAGO, IL
    ZIP 60612
  • Facility Phone: 312 864-2334
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: VESNA M. PETRONIC-ROSIC
  • NPI Number: 1558320861
  • Taxonomy: 207RH0003X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2217103
LAB Type Physician Office
Facility Name DIVISION OF DERMATOLOGY - COOK COUNTY
Street 1950 W POLK ST, SUITE 4407
City CHICAGO
State IL
ZIP 60612
Phone 312 864-2334
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 12/29/2022
Certificate Expiration Date 10/31/2025
Facility Type Physician Office
Lab Director VESNA M. PETRONIC-ROSIC

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