14D0669041 CLIA NUMBER - PERSONAL PHYSICIANS SC

Laboratory Demographics

  • CLIA Code: 14D0669041
  • Facility Name: PERSONAL PHYSICIANS SC
  • Facility Address: 5909 W 35TH ST
    CICERO, IL
    ZIP 60804
  • Facility Phone: 708 652-2040
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHISHIR JAIN
  • NPI Number: 1215066345
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D0669041
LAB Type Physician Office
Facility Name PERSONAL PHYSICIANS SC
Street 5909 W 35TH ST
City CICERO
State IL
ZIP 60804
Phone 708 652-2040
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/18/2023
Certificate Expiration Date 11/17/2025
Facility Type Physician Office
Lab Director SHISHIR JAIN

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