14D2296263 CLIA NUMBER - RECOVERY CONCEPTS III, LLC

Laboratory Demographics

  • CLIA Code: 14D2296263
  • Facility Name: RECOVERY CONCEPTS III, LLC
  • Facility Address: 6334 S ARCHER AVE - STE A
    CHICAGO, IL
    ZIP 60632
  • Facility Phone: 773 306-2385
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: SUSAN K. MANTELL
  • NPI Number: 1497427223
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2296263
LAB Type Practitioner Other
Facility Name RECOVERY CONCEPTS III, LLC
Street 6334 S ARCHER AVE - STE A
City CHICAGO
State IL
ZIP 60632
Phone 773 306-2385
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/26/2023
Certificate Expiration Date 12/25/2025
Facility Type Practitioner Other
Lab Director SUSAN K. MANTELL

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