14D0972470 CLIA NUMBER - PEDIATRICS AND DERMATOLOGY SC

Laboratory Demographics

  • CLIA Code: 14D0972470
  • Facility Name: PEDIATRICS AND DERMATOLOGY SC
  • Facility Address: 6211 NORTH MILWAUKEE AVENUE
    CHICAGO, IL
    ZIP 60646
  • Facility Phone: 773 774-6677
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MIROSLAWA A. DULCZEWSKA MILLER MD
  • NPI Number: 1437105947
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D0972470
LAB Type Physician Office
Facility Name PEDIATRICS AND DERMATOLOGY SC
Street 6211 NORTH MILWAUKEE AVENUE
City CHICAGO
State IL
ZIP 60646
Phone 773 774-6677
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 4/7/2024
Certificate Expiration Date 4/6/2026
Facility Type Physician Office
Lab Director MIROSLAWA A. DULCZEWSKA MILLER MD

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