14D0943148 CLIA NUMBER - T AHMAD MD SC

Laboratory Demographics

  • CLIA Code: 14D0943148
  • Facility Name: T AHMAD MD SC
  • Facility Address: 21807 W GRANT HWY
    MARENGO, IL
    ZIP 60152
  • Facility Phone: 815 568-1074
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TANVEER AHMAD
  • NPI Number: 1790078111
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D0943148
LAB Type Physician Office
Facility Name T AHMAD MD SC
Street 21807 W GRANT HWY
City MARENGO
State IL
ZIP 60152
Phone 815 568-1074
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/23/2024
Certificate Expiration Date 3/22/2026
Facility Type Physician Office
Lab Director TANVEER AHMAD

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