14D0692325 CLIA NUMBER - V SUSARLA MD SC

Laboratory Demographics

  • CLIA Code: 14D0692325
  • Facility Name: V SUSARLA MD SC
  • Facility Address: 860 SUMMIT SUITE 123
    ELGIN, IL
    ZIP 60120
  • Facility Phone: 847 741-0026
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: VIS SUSARLA MD
  • NPI Number: 1952583783
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D0692325
LAB Type Physician Office
Facility Name V SUSARLA MD SC
Street 860 SUMMIT SUITE 123
City ELGIN
State IL
ZIP 60120
Phone 847 741-0026
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 3/22/2024
Certificate Expiration Date 3/21/2026
Facility Type Physician Office
Lab Director VIS SUSARLA MD

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