Clinical Laboratory Information
Similar CLIA Codes
|
|
CLIA Number
|
14D0425677
|
|
Clinical laboratory number
|
|
Lab Name
|
PRIME HEALTHCARE IL MED GROUP LLC - PRIMARY CARE
|
|
Laboratory Name
|
|
Lab Type
|
Physician Office
|
|
Laboratory Type
|
|
Certificate Type
|
Waiver
|
|
Clinical laboratory certificate type
|
Contacts |
|
Phone
|
909-357-5029
|
|
Laboratory telephone number
|
|
Fax
|
773-267-6793
|
|
Fax number of the provider.
|
Facility Location |
|
Street Address
|
3048 W PETERSON AVE
|
|
Primary location adress line
|
|
City
|
CHICAGO
|
|
Primary location city name
|
|
State
|
IL
|
|
Primary location state name
|
|
Zip
|
60659
|
|
Primary location postal code
|