14D2253883 CLIA NUMBER - CHICAGO PCR LAB SERVICES LLC

Laboratory Demographics

CLIA Number: 14D2253883

Facility Name: CHICAGO PCR LAB SERVICES LLC

Facility Address:
4176 W MONTROSE AVE
CHICAGO, IL
ZIP 60641
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Facility Phone Number: 708 831-8417

Facility Type: Independent

Certificate Type: Certificate of Compliance

NPI Number: 1457876732

Taxonomy: 213E00000X - Podiatrist
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.

CLIA Record

Field Name	Field Value
CLIA Number	14D2253883
LAB Type	Independent
Facility Name	CHICAGO PCR LAB SERVICES LLC
Street	4176 W MONTROSE AVE
City	CHICAGO
State	IL
ZIP	60641
Phone	708 831-8417
CertificateType	2
CertificateEffectiveDate	7/1/2022
CertificateExpirationDate	6/30/2024
FacilityType	Compliance

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