14D0425227 CLIA NUMBER - JEROME ANTONY MD

Laboratory Demographics

  • CLIA Code: 14D0425227
  • Facility Name: JEROME ANTONY MD
  • Facility Address: 327 W 76TH
    CHICAGO, IL
    ZIP 60620
  • Facility Phone: 773 224-6837
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JEROME ANTONY MD
  • NPI Number: 1639122583
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D0425227
LAB Type Physician Office
Facility Name JEROME ANTONY MD
Street 327 W 76TH
City CHICAGO
State IL
ZIP 60620
Phone 773 224-6837
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director JEROME ANTONY MD

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