14D0690576 CLIA NUMBER - OB-GYN SOUTHWEST SC

Laboratory Demographics

CLIA Number: 14D0690576

Facility Name: OB-GYN SOUTHWEST SC

Facility Address:
13011 S 104TH AVE
PALOS PARK, IL
ZIP 60464
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Facility Phone Number: 708 361-5222

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1205995321

Taxonomy: 207V00000X - Obstetrics & Gynecology
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

CLIA Record

Field Name	Field Value
CLIA Number	14D0690576
LAB Type	Physician Office
Facility Name	OB-GYN SOUTHWEST SC
Street	13011 S 104TH AVE
City	PALOS PARK
State	IL
ZIP	60464
Phone	708 361-5222
CertificateType	3
CertificateEffectiveDate	12/1/2022
CertificateExpirationDate	11/30/2024
FacilityType	PPMP

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