14D0420330 CLIA NUMBER - SOUTHWEST PEDIATRICS

Laboratory Demographics

  • CLIA Code: 14D0420330
  • Facility Name: SOUTHWEST PEDIATRICS
  • Facility Address: 1 PARK PLACE, 8100 W 119TH ST
    PALOS PARK, IL
    ZIP 60464
  • Facility Phone: 708 361-3300
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: DR. GRACE CARREON
  • NPI Number: 1427094416
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 14D0420330
LAB Type Physician Office
Facility Name SOUTHWEST PEDIATRICS
Street 1 PARK PLACE, 8100 W 119TH ST
City PALOS PARK
State IL
ZIP 60464
Phone 708 361-3300
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 12/23/2023
Certificate Expiration Date 12/22/2025
Facility Type Physician Office
Lab Director DR. GRACE CARREON

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