14D0419820 CLIA NUMBER - P & D MEDICAL SC

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Laboratory Demographics

CLIA Number: 14D0419820

Facility Name: P & D MEDICAL SC

Facility Address:
4201 W 95TH STREET
OAK LAWN, IL
ZIP 60453
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Facility Phone Number: 708 636-1466

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1124129697

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

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
CertificateType	4
CertificateEffectiveDate	9/10/2023
CertificateExpirationDate	9/9/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024