14D0681246 CLIA NUMBER - MIDWEST ALLERGY INC

Laboratory Demographics

CLIA Number: 14D0681246

Facility Name: MIDWEST ALLERGY INC

Facility Address:
10001 W ROOSEVELT RD, STE 304
WESTCHESTER, IL
ZIP 60154
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Facility Phone Number: 708 344-3550

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1356642912

Taxonomy: 207RA0201X - Internal Medicine
An internist doctor of osteopathy that specializes in the treatment of allergy and immunologic disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Special Qualifications in the field of Allergy & Immunology.

CLIA Record

Field Name	Field Value
CLIA Number	14D0681246
LAB Type	Physician Office
Facility Name	MIDWEST ALLERGY INC
Street	10001 W ROOSEVELT RD, STE 304
City	WESTCHESTER
State	IL
ZIP	60154
Phone	708 344-3550
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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