14D0998546 CLIA NUMBER - CLODAGH T RYAN M D

Laboratory Demographics

  • CLIA Code: 14D0998546
  • Facility Name: CLODAGH T RYAN M D
  • Facility Address: 1400 47TH ST - STE 1
    LA GRANGE, IL
    ZIP 60525
  • Facility Phone: 708 571-2272
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CLODAGH T. RYAN M D
  • NPI Number: 1205042975
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D0998546
LAB Type Physician Office
Facility Name CLODAGH T RYAN M D
Street 1400 47TH ST - STE 1
City LA GRANGE
State IL
ZIP 60525
Phone 708 571-2272
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/18/2024
Certificate Expiration Date 4/17/2026
Facility Type Physician Office
Lab Director CLODAGH T. RYAN M D

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