14D0892412 CLIA NUMBER - MADO HEALTHCARE - DOUGLAS PARK

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CLIA Record

Field Name Field Value
CLIA Number 14D0892412
LAB Type Other
Facility Name MADO HEALTHCARE - DOUGLAS PARK
Street 1550 SOUTH ALBANY
City CHICAGO
State IL
ZIP 60623
Phone 773 277-6868
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/29/2024
Certificate Expiration Date 9/28/2026
Facility Type Other
Lab Director MARDY GIBBS

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