14D0693804 CLIA NUMBER - PRAFULLA K KONERU MD SC

Laboratory Demographics

  • CLIA Code: 14D0693804
  • Facility Name: PRAFULLA K KONERU MD SC
  • Facility Address: S EXECUTIVE COURT STE 1
    SOUTH BARRINGTON, IL
    ZIP 60010
  • Facility Phone: 847 382-8200
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: PRAFULLA K. KONERU MD
  • NPI Number: 1093700072
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 14D0693804
LAB Type Physician Office
Facility Name PRAFULLA K KONERU MD SC
Street S EXECUTIVE COURT STE 1
City SOUTH BARRINGTON
State IL
ZIP 60010
Phone 847 382-8200
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 3/7/2024
Certificate Expiration Date 3/6/2026
Facility Type Physician Office
Lab Director PRAFULLA K. KONERU MD

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