14D2278496 CLIA NUMBER - KENWOOD DIALYSIS TOTAL RENAL CARE INC

Laboratory Demographics

  • CLIA Code: 14D2278496
  • Facility Name: KENWOOD DIALYSIS TOTAL RENAL CARE INC
  • Facility Address: 4259 S COTTAGE GROVE AVE - STE 100
    CHICAGO, IL
    ZIP 60653
  • Facility Phone: 773 285-3621
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: BHRATHI REDDDY
  • NPI Number: 1891009619
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2278496
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name KENWOOD DIALYSIS TOTAL RENAL CARE INC
Street 4259 S COTTAGE GROVE AVE - STE 100
City CHICAGO
State IL
ZIP 60653
Phone 773 285-3621
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/17/2025
Certificate Expiration Date 3/16/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director BHRATHI REDDDY

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