14D0966843 CLIA NUMBER - EDM CONSULTANT SERVICES RIM JOUBRAN MD

Laboratory Demographics

  • CLIA Code: 14D0966843
  • Facility Name: EDM CONSULTANT SERVICES RIM JOUBRAN MD
  • Facility Address: 675 W NORTH AVE SUITE 104
    MELROSE PARK, IL
    ZIP 60160
  • Facility Phone: 708 681-7695
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RIM JOUBRAN
  • NPI Number: 1497792840
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D0966843
LAB Type Physician Office
Facility Name EDM CONSULTANT SERVICES RIM JOUBRAN MD
Street 675 W NORTH AVE SUITE 104
City MELROSE PARK
State IL
ZIP 60160
Phone 708 681-7695
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/26/2023
Certificate Expiration Date 10/25/2025
Facility Type Physician Office
Lab Director RIM JOUBRAN

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