14D2326036 CLIA NUMBER - ELEVATED HEALTH & WELLNESS

Laboratory Demographics

  • CLIA Code: 14D2326036
  • Facility Name: ELEVATED HEALTH & WELLNESS
  • Facility Address: 2315 E 93RD ST - STE 339
    CHICAGO, IL
    ZIP 60614
  • Facility Phone: 312 927-1897
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: KEYONA D. GAYLES
  • NPI Number: 1205624186
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 14D2326036
LAB Type Practitioner Other
Facility Name ELEVATED HEALTH & WELLNESS
Street 2315 E 93RD ST - STE 339
City CHICAGO
State IL
ZIP 60614
Phone 312 927-1897
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/25/2025
Certificate Expiration Date 6/24/2027
Facility Type Practitioner Other
Lab Director KEYONA D. GAYLES

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