14D2324672 CLIA NUMBER - MICHIGAN AVENUE ENT

Laboratory Demographics

  • CLIA Code: 14D2324672
  • Facility Name: MICHIGAN AVENUE ENT
  • Facility Address: 180 N MICHIGAN AVE - STE 1700
    CHICAGO, IL
    ZIP 60601
  • Facility Phone: 312 229-9000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAMES A. RUNKE
  • NPI Number: 1043735483
  • Taxonomy: 207Y00000X - Otolaryngology

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CLIA Record

Field Name Field Value
CLIA Number 14D2324672
LAB Type Physician Office
Facility Name MICHIGAN AVENUE ENT
Street 180 N MICHIGAN AVE - STE 1700
City CHICAGO
State IL
ZIP 60601
Phone 312 229-9000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/29/2025
Certificate Expiration Date 5/28/2027
Facility Type Physician Office
Lab Director JAMES A. RUNKE

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