14D0980016 CLIA NUMBER - WILLIAM E OTERO MD/OTERO MEDICAL CTR

Laboratory Demographics

  • CLIA Code: 14D0980016
  • Facility Name: WILLIAM E OTERO MD/OTERO MEDICAL CTR
  • Facility Address: 4911 W FULLERTON AVE
    CHICAGO, IL
    ZIP 60639
  • Facility Phone: 773 772-4900
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WILLIAM E. OTERO MD
  • NPI Number: 1588776884
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D0980016
LAB Type Physician Office
Facility Name WILLIAM E OTERO MD/OTERO MEDICAL CTR
Street 4911 W FULLERTON AVE
City CHICAGO
State IL
ZIP 60639
Phone 773 772-4900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/9/2024
Certificate Expiration Date 11/8/2026
Facility Type Physician Office
Lab Director WILLIAM E. OTERO MD

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