14D0963180 CLIA NUMBER - MANSOOR KHAN MD SC/WIMMER MED PLAZA

Laboratory Demographics

  • CLIA Code: 14D0963180
  • Facility Name: MANSOOR KHAN MD SC/WIMMER MED PLAZA
  • Facility Address: 810 BIESTERFIELD RD SUITE 407
    ELK GROVE VILLAGE, IL
    ZIP 60007
  • Facility Phone: 847 952-7181
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MANSOOR KHAN M D
  • NPI Number: 1053490920
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D0963180
LAB Type Physician Office
Facility Name MANSOOR KHAN MD SC/WIMMER MED PLAZA
Street 810 BIESTERFIELD RD SUITE 407
City ELK GROVE VILLAGE
State IL
ZIP 60007
Phone 847 952-7181
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/23/2025
Certificate Expiration Date 7/22/2027
Facility Type Physician Office
Lab Director MANSOOR KHAN M D

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