14D2305607 CLIA NUMBER - RYZE ON THE AVENUE

Laboratory Demographics

  • CLIA Code: 14D2305607
  • Facility Name: RYZE ON THE AVENUE
  • Facility Address: 3400 S INDIANA AVE
    CHICAGO, IL
    ZIP 60616
  • Facility Phone: 312 842-5000
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: BRANDY L. GREGORY
  • NPI Number: 1891479895
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 14D2305607
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name RYZE ON THE AVENUE
Street 3400 S INDIANA AVE
City CHICAGO
State IL
ZIP 60616
Phone 312 842-5000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/4/2024
Certificate Expiration Date 6/3/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director BRANDY L. GREGORY

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