14D0873226 CLIA NUMBER - EDGAR RIOS M D S C

Laboratory Demographics

  • CLIA Code: 14D0873226
  • Facility Name: EDGAR RIOS M D S C
  • Facility Address: 4152 W 26TH STREET
    CHICAGO, IL
    ZIP 60623
  • Facility Phone: 773 521-1100
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EDGAR RIOS MD
  • NPI Number: 1962588608
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 14D0873226
LAB Type Physician Office
Facility Name EDGAR RIOS M D S C
Street 4152 W 26TH STREET
City CHICAGO
State IL
ZIP 60623
Phone 773 521-1100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/11/2023
Certificate Expiration Date 12/10/2025
Facility Type Physician Office
Lab Director EDGAR RIOS MD

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