14D0964903 CLIA NUMBER - SUSAN RIFE FAMILY MEDICINE SC

Laboratory Demographics

  • CLIA Code: 14D0964903
  • Facility Name: SUSAN RIFE FAMILY MEDICINE SC
  • Facility Address: 10755 W 163RD PLACE
    ORLAND PARK, IL
    ZIP 60467
  • Facility Phone: 708 873-1187
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SUSAN B. RIFE DO
  • NPI Number: 1720067234
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D0964903
LAB Type Physician Office
Facility Name SUSAN RIFE FAMILY MEDICINE SC
Street 10755 W 163RD PLACE
City ORLAND PARK
State IL
ZIP 60467
Phone 708 873-1187
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/29/2025
Certificate Expiration Date 4/28/2027
Facility Type Physician Office
Lab Director SUSAN B. RIFE DO

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