14D2242919 CLIA NUMBER - DIALYSIS CARE CENTER VOLLMER

Laboratory Demographics

CLIA Number: 14D2242919

Facility Name: DIALYSIS CARE CENTER VOLLMER

Facility Address:
222 VOLLMER RD
CHICAGO HEIGHTS, IL
ZIP 60411
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Facility Phone Number: 708 645-1000

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1154073278

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D2242919
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	DIALYSIS CARE CENTER VOLLMER
Street	222 VOLLMER RD
City	CHICAGO HEIGHTS
State	IL
ZIP	60411
Phone	708 645-1000
CertificateType	4
CertificateEffectiveDate	11/15/2023
CertificateExpirationDate	11/14/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024