Clinical Laboratory Information
Similar CLIA Codes
|
|
CLIA Number
|
14D0944993
|
|
Clinical laboratory number
|
|
Lab Name
|
PROVIDEA HEALTH PARTNERS LLC
|
|
Laboratory Name
|
|
Lab Type
|
Physician Office
|
|
Laboratory Type
|
|
Certificate Type
|
PPMP
|
|
Clinical laboratory certificate type
|
Contacts |
|
Phone
|
708-425-1907
|
|
Laboratory telephone number
|
|
Fax
|
708-422-4253
|
|
Fax number of the provider.
|
Facility Location |
|
Street Address
|
9730 S WESTERN AVE - STE 700
|
|
Primary location adress line
|
|
City
|
EVERGREEN PARK
|
|
Primary location city name
|
|
State
|
IL
|
|
Primary location state name
|
|
Zip
|
60805
|
|
Primary location postal code
|