Clinical Laboratory Information
Similar CLIA Codes
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CLIA Number
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14D2309577
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Clinical laboratory number
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Lab Name
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PROVIDENCE FARM, LLC
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Laboratory Name
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Lab Type
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Other - TRANSITIONAL LIVING SOBER
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Laboratory Type
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Certificate Type
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Waiver
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Clinical laboratory certificate type
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Contacts |
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Phone
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847-409-6230
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Laboratory telephone number
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Fax
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N/S (NOT SPECIFIED)
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Fax number of the provider.
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Facility Location |
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Street Address
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479 LEE ST
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Primary location adress line
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City
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NORTHBROOK
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Primary location city name
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State
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IL
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Primary location state name
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Zip
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60062
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Primary location postal code
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