14D0966136 CLIA NUMBER - RICHARD E ODONNELL DO SC

Laboratory Demographics

  • CLIA Code: 14D0966136
  • Facility Name: RICHARD E ODONNELL DO SC
  • Facility Address: 3927 W 95TH STREET
    EVERGREEN PARK, IL
    ZIP 60805
  • Facility Phone: 708 952-4566
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RICHARD E. ODONNELL
  • NPI Number: 1184600207
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D0966136
LAB Type Physician Office
Facility Name RICHARD E ODONNELL DO SC
Street 3927 W 95TH STREET
City EVERGREEN PARK
State IL
ZIP 60805
Phone 708 952-4566
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/7/2023
Certificate Expiration Date 10/6/2025
Facility Type Physician Office
Lab Director RICHARD E. ODONNELL

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