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14D0873226 CLIA NUMBER - EDGAR RIOS M D S C

Laboratory Demographics

CLIA Number: 14D0873226

Facility Name: EDGAR RIOS M D S C

Facility Address:
4152 W 26TH STREET
CHICAGO, IL
ZIP 60623
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Facility Phone Number: 773 521-1100

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1962588608

Taxonomy: 208800000X - Urology
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

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
CertificateType 4
CertificateEffectiveDate 12/11/2023
CertificateExpirationDate 12/10/2025
FacilityType Waiver

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