14D2299205 CLIA NUMBER - MIDWEST EXPRESS CLINIC - LOGAN SQUARE

Laboratory Demographics

  • CLIA Code: 14D2299205
  • Facility Name: MIDWEST EXPRESS CLINIC - LOGAN SQUARE
  • Facility Address: 3333 W FULLERTON AVE - UNIT B
    CHICAGO, IL
    ZIP 60647
  • Facility Phone: 773 257-0610
  • Facility Type: Other - URGENT CARE
  • Facility Type: Waiver
  • Lab Director: LINDA PALUMBO
  • NPI Number: 1902647894
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2299205
LAB Type Other - URGENT CARE
Facility Name MIDWEST EXPRESS CLINIC - LOGAN SQUARE
Street 3333 W FULLERTON AVE - UNIT B
City CHICAGO
State IL
ZIP 60647
Phone 773 257-0610
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/15/2024
Certificate Expiration Date 2/14/2026
Facility Type Other - URGENT CARE
Lab Director LINDA PALUMBO

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