14D2229661 CLIA NUMBER - PROVISO AREA EXCEPTIONAL CHILDREN (PAEC)

Laboratory Demographics

  • CLIA Code: 14D2229661
  • Facility Name: PROVISO AREA EXCEPTIONAL CHILDREN (PAEC)
  • Facility Address: 1000 VAN BUREN ST
    MAYWOOD, IL
    ZIP 60153
  • Facility Phone: 708 450-2100
  • Facility Type: School/Student Health Service
  • Facility Type: Waiver
  • Lab Director: CATHY L. OBRADOVICH
  • NPI Number: 1578944344
  • Taxonomy: 251300000X - Local Education Agency (LEA)

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CLIA Record

Field Name Field Value
CLIA Number 14D2229661
LAB Type School/Student Health Service
Facility Name PROVISO AREA EXCEPTIONAL CHILDREN (PAEC)
Street 1000 VAN BUREN ST
City MAYWOOD
State IL
ZIP 60153
Phone 708 450-2100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/15/2025
Certificate Expiration Date 7/14/2027
Facility Type School/Student Health Service
Lab Director CATHY L. OBRADOVICH

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