14D2319755 CLIA NUMBER - ENHANCED HEALTH PLLC

Laboratory Demographics

  • CLIA Code: 14D2319755
  • Facility Name: ENHANCED HEALTH PLLC
  • Facility Address: 7627 LAKE ST - STE 206 PMB 1152
    RIVER FOREST, IL
    ZIP 60305
  • Facility Phone: 312 244-5681
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: SHATARA COLEMAN
  • NPI Number: 1851182182
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 14D2319755
LAB Type Mobile Laboratory
Facility Name ENHANCED HEALTH PLLC
Street 7627 LAKE ST - STE 206 PMB 1152
City RIVER FOREST
State IL
ZIP 60305
Phone 312 244-5681
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/6/2025
Certificate Expiration Date 3/5/2027
Facility Type Mobile Laboratory
Lab Director SHATARA COLEMAN

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