14D2323940 CLIA NUMBER - IMANI COMMUNITY CLINIC

Laboratory Demographics

  • CLIA Code: 14D2323940
  • Facility Name: IMANI COMMUNITY CLINIC
  • Facility Address: 502 W 138TH ST
    RIVERDALE, IL
    ZIP 60827
  • Facility Phone: 312 763-6162
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: JOSEPH OFISI
  • NPI Number: 1053107813
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2323940
LAB Type Independent
Facility Name IMANI COMMUNITY CLINIC
Street 502 W 138TH ST
City RIVERDALE
State IL
ZIP 60827
Phone 312 763-6162
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 Independent
Lab Director JOSEPH OFISI

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