14D2242480 CLIA NUMBER - CLARK, NELSON, AND ASSOCIATES, INC

Laboratory Demographics

  • CLIA Code: 14D2242480
  • Facility Name: CLARK, NELSON, AND ASSOCIATES, INC
  • Facility Address: 2600 S MICHIGAN AVE - STE LLD
    CHICAGO, IL
    ZIP 60616
  • Facility Phone: (312) 866-4642
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHAMMONA CLARK
  • NPI Number: 1902457450
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 14D2242480
LAB Type Physician Office
Facility Name CLARK, NELSON, AND ASSOCIATES, INC
Street 2600 S MICHIGAN AVE - STE LLD
City CHICAGO
State IL
ZIP 60616
Phone 3128664642
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/9/2025
Certificate Expiration Date 11/8/2027
Facility Type Physician Office
Lab Director SHAMMONA CLARK

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