14D2249050 CLIA NUMBER - ILLINIOS TECH LABS INC

Laboratory Demographics

CLIA Number: 14D2249050

Facility Name: ILLINIOS TECH LABS INC

Facility Address:
1818 SKOKIE BLVD
NORTHBROOK, IL
ZIP 60062
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Facility Phone Number: 323 681-3033

Facility Type: Independent

Certificate Type: Waiver

NPI Number: 1679639967

Taxonomy: 315P00000X - Intermediate Care Facility, Intellectual Disabilities
An intermediate care facility providing services for individuals with intellectual disabilities.

CLIA Record

Field Name	Field Value
CLIA Number	14D2249050
LAB Type	Independent
Facility Name	ILLINIOS TECH LABS INC
Street	1818 SKOKIE BLVD
City	NORTHBROOK
State	IL
ZIP	60062
Phone	323 681-3033
CertificateType	4
CertificateEffectiveDate	1/18/2024
CertificateExpirationDate	1/17/2026
FacilityType	Waiver

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