14D0420032 CLIA NUMBER - BHARTI AMIN MD INGALLS FAMILY CARE CENTER

Laboratory Demographics

  • CLIA Code: 14D0420032
  • Facility Name: BHARTI AMIN MD INGALLS FAMILY CARE CENTER
  • Facility Address: 4647 W LINCOLN HWY
    MATTESON, IL
    ZIP 60443
  • Facility Phone: 708 748-5910
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BHARTI N. AMIN
  • NPI Number: 1265458343
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 14D0420032
LAB Type Physician Office
Facility Name BHARTI AMIN MD INGALLS FAMILY CARE CENTER
Street 4647 W LINCOLN HWY
City MATTESON
State IL
ZIP 60443
Phone 708 748-5910
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/1/2025
Certificate Expiration Date 2/28/2027
Facility Type Physician Office
Lab Director BHARTI N. AMIN

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