14D2311668 CLIA NUMBER - PCC AUSTIN FAMILY HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 14D2311668
  • Facility Name: PCC AUSTIN FAMILY HEALTH CENTER
  • Facility Address: 5461 W LAKE ST
    CHICAGO, IL
    ZIP 60644
  • Facility Phone: 773 378-3347
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: ANDREA HAYNES
  • NPI Number: 1609892223
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2311668
LAB Type Federally Qualified Health Center
Facility Name PCC AUSTIN FAMILY HEALTH CENTER
Street 5461 W LAKE ST
City CHICAGO
State IL
ZIP 60644
Phone 773 378-3347
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/26/2024
Certificate Expiration Date 9/25/2026
Facility Type Federally Qualified Health Center
Lab Director ANDREA HAYNES

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