14D0982074 CLIA NUMBER - FAIRVIEW OGDEN MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 14D0982074
  • Facility Name: FAIRVIEW OGDEN MEDICAL GROUP
  • Facility Address: 4121 FAIRVIEW AVENUE SUITE L1
    DOWNERS GROVE, IL
    ZIP 60515
  • Facility Phone: 630 968-4790
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ZAINULABUDDIN SYED MD
  • NPI Number: 1962683359
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D0982074
LAB Type Physician Office
Facility Name FAIRVIEW OGDEN MEDICAL GROUP
Street 4121 FAIRVIEW AVENUE SUITE L1
City DOWNERS GROVE
State IL
ZIP 60515
Phone 630 968-4790
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/16/2025
Certificate Expiration Date 1/15/2027
Facility Type Physician Office
Lab Director ZAINULABUDDIN SYED MD

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