14D2227250 CLIA NUMBER - THOMPSON MEDICAL INCORPORATED

Laboratory Demographics

  • CLIA Code: 14D2227250
  • Facility Name: THOMPSON MEDICAL INCORPORATED
  • Facility Address: 4564 N BROADWAY ST
    CHICAGO, IL
    ZIP 60640
  • Facility Phone: (773) 271-9700
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: THOMPSON DZIDZA
  • NPI Number: 1356814503
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2227250
LAB Type Physician Office
Facility Name THOMPSON MEDICAL INCORPORATED
Street 4564 N BROADWAY ST
City CHICAGO
State IL
ZIP 60640
Phone 7732719700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/9/2025
Certificate Expiration Date 6/8/2027
Facility Type Physician Office
Lab Director THOMPSON DZIDZA

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