14D2307186 CLIA NUMBER - WESTCARE ILLINOIS, INC

Laboratory Demographics

  • CLIA Code: 14D2307186
  • Facility Name: WESTCARE ILLINOIS, INC
  • Facility Address: 1100 W CERMAK RD - STE B414
    CHICAGO, IL
    ZIP 60608
  • Facility Phone: 702 290-1316
  • Facility Type: Other - BH OUTPATIENT CLINIC
  • Facility Type: Waiver
  • Lab Director: CHARLENE A. LETCHFORD
  • NPI Number: 1821535618
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2307186
LAB Type Other - BH OUTPATIENT CLINIC
Facility Name WESTCARE ILLINOIS, INC
Street 1100 W CERMAK RD - STE B414
City CHICAGO
State IL
ZIP 60608
Phone 702 290-1316
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/2/2024
Certificate Expiration Date 7/1/2026
Facility Type Other - BH OUTPATIENT CLINIC
Lab Director CHARLENE A. LETCHFORD

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