14D0907868 CLIA NUMBER - METRO INFECTIOUS DISEASE CONSULTANTS P L C

Laboratory Demographics

  • CLIA Code: 14D0907868
  • Facility Name: METRO INFECTIOUS DISEASE CONSULTANTS P L C
  • Facility Address: 901 MCCLINTOCK DR, STE 202
    BURR RIDGE, IL
    ZIP 60527
  • Facility Phone: 630 654-4201
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RUSSELL M. PETRAK M D
  • NPI Number: 1811154354
  • Taxonomy: 207RI0200X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D0907868
LAB Type Physician Office
Facility Name METRO INFECTIOUS DISEASE CONSULTANTS P L C
Street 901 MCCLINTOCK DR, STE 202
City BURR RIDGE
State IL
ZIP 60527
Phone 630 654-4201
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/7/2024
Certificate Expiration Date 4/6/2026
Facility Type Physician Office
Lab Director RUSSELL M. PETRAK M D

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This page was last updated on: 6/4/2025