14D0966846 CLIA NUMBER - PEDIATRICS NEONATOLOGY ATTN OFELIA B AYUSTE MD

Laboratory Demographics

  • CLIA Code: 14D0966846
  • Facility Name: PEDIATRICS NEONATOLOGY ATTN OFELIA B AYUSTE MD
  • Facility Address: 4121 FAIRVIEW AVE - STE 100
    DOWNERS GROVE, IL
    ZIP 60515
  • Facility Phone: 630 971-8881
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: OFELIA B. AYUSTE MD
  • NPI Number: 1639221682
  • Taxonomy: 261QR0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D0966846
LAB Type Physician Office
Facility Name PEDIATRICS NEONATOLOGY ATTN OFELIA B AYUSTE MD
Street 4121 FAIRVIEW AVE - STE 100
City DOWNERS GROVE
State IL
ZIP 60515
Phone 630 971-8881
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 OFELIA B. AYUSTE MD

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