14D2265022 CLIA NUMBER - MAYWOOD SLF

Laboratory Demographics

  • CLIA Code: 14D2265022
  • Facility Name: MAYWOOD SLF
  • Facility Address: 316 RANDOLPH ST
    MAYWOOD, IL
    ZIP 60153
  • Facility Phone: 708 786-9070
  • Facility Type: Other - SUPPORTIVE LIVING
  • Facility Type: Waiver
  • Lab Director: CRYSTAL L. WILLS
  • NPI Number: 1770210825
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 14D2265022
LAB Type Other - SUPPORTIVE LIVING
Facility Name MAYWOOD SLF
Street 316 RANDOLPH ST
City MAYWOOD
State IL
ZIP 60153
Phone 708 786-9070
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/21/2024
Certificate Expiration Date 7/20/2026
Facility Type Other - SUPPORTIVE LIVING
Lab Director CRYSTAL L. WILLS

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