14D2312933 CLIA NUMBER - QUEST DIAGNOSTICS PRIMECARE YOUNG FAMILY

Laboratory Demographics

  • CLIA Code: 14D2312933
  • Facility Name: QUEST DIAGNOSTICS PRIMECARE YOUNG FAMILY
  • Facility Address: 1431 N WESTERN AVE - STE 202
    CHICAGO, IL
    ZIP 60622
  • Facility Phone: 773 267-2272
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: MATTHEW KRAIZA
  • NPI Number: 1568048205
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 14D2312933
LAB Type Independent
Facility Name QUEST DIAGNOSTICS PRIMECARE YOUNG FAMILY
Street 1431 N WESTERN AVE - STE 202
City CHICAGO
State IL
ZIP 60622
Phone 773 267-2272
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/22/2024
Certificate Expiration Date 10/21/2026
Facility Type Independent
Lab Director MATTHEW KRAIZA

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