14D2283638 CLIA NUMBER - CONRAD CARE, INC

Laboratory Demographics

  • CLIA Code: 14D2283638
  • Facility Name: CONRAD CARE, INC
  • Facility Address: 3525 W PETERSON AVE - STE 505
    CHICAGO, IL
    ZIP 60659
  • Facility Phone: 312 204-7255
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: NICHOLAS EFOSA AGBONIFO
  • NPI Number: 1821763947
  • Taxonomy: 376J00000X - Homemaker

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CLIA Record

Field Name Field Value
CLIA Number 14D2283638
LAB Type Home Health Agency
Facility Name CONRAD CARE, INC
Street 3525 W PETERSON AVE - STE 505
City CHICAGO
State IL
ZIP 60659
Phone 312 204-7255
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/11/2025
Certificate Expiration Date 6/10/2027
Facility Type Home Health Agency
Lab Director NICHOLAS EFOSA AGBONIFO

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