14D2284487 CLIA NUMBER - FORT CARE, LLC

Laboratory Demographics

  • CLIA Code: 14D2284487
  • Facility Name: FORT CARE, LLC
  • Facility Address: 18241 WEST ST - STE 209
    LANSING, IL
    ZIP 60438
  • Facility Phone: 800 897-4575
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: LATEISHA N. FORT
  • NPI Number: 1841906047
  • Taxonomy: 261QH0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2284487
LAB Type Mobile Laboratory
Facility Name FORT CARE, LLC
Street 18241 WEST ST - STE 209
City LANSING
State IL
ZIP 60438
Phone 800 897-4575
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/23/2025
Certificate Expiration Date 6/22/2027
Facility Type Mobile Laboratory
Lab Director LATEISHA N. FORT

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