14D0419820 CLIA NUMBER - P & D MEDICAL SC

Laboratory Demographics

  • CLIA Code: 14D0419820
  • Facility Name: P & D MEDICAL SC
  • Facility Address: 4201 W 95TH STREET
    OAK LAWN, IL
    ZIP 60453
  • Facility Phone: 708 636-1466
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PETER DRAGISIC MD
  • NPI Number: 1124129697
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D0419820
LAB Type Physician Office
Facility Name P & D MEDICAL SC
Street 4201 W 95TH STREET
City OAK LAWN
State IL
ZIP 60453
Phone 708 636-1466
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/10/2025
Certificate Expiration Date 9/9/2027
Facility Type Physician Office
Lab Director PETER DRAGISIC MD

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