14D2323909 CLIA NUMBER - A SAFE HAVEN - 2750

Laboratory Demographics

  • CLIA Code: 14D2323909
  • Facility Name: A SAFE HAVEN - 2750
  • Facility Address: 2750 W ROOSEVELT ROAD
    CHICAGO, IL
    ZIP 60608
  • Facility Phone: 773 435-8300
  • Facility Type: Other - SUPR TX PROVIDER/RH
  • Facility Type: Waiver
  • Lab Director: DANA SETHNESS
  • NPI Number: 1689451858
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2323909
LAB Type Other - SUPR TX PROVIDER/RH
Facility Name A SAFE HAVEN - 2750
Street 2750 W ROOSEVELT ROAD
City CHICAGO
State IL
ZIP 60608
Phone 773 435-8300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/15/2025
Certificate Expiration Date 5/14/2027
Facility Type Other - SUPR TX PROVIDER/RH
Lab Director DANA SETHNESS

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