14D1010978 CLIA NUMBER - SANJAY PETHKAR MD SC

Laboratory Demographics

  • CLIA Code: 14D1010978
  • Facility Name: SANJAY PETHKAR MD SC
  • Facility Address: 13415 S ROUTE 59
    PLAINFIELD, IL
    ZIP 60585
  • Facility Phone: 815 212-3942
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SANJAY PETHKAR
  • NPI Number: 1134181829
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D1010978
LAB Type Physician Office
Facility Name SANJAY PETHKAR MD SC
Street 13415 S ROUTE 59
City PLAINFIELD
State IL
ZIP 60585
Phone 815 212-3942
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/28/2025
Certificate Expiration Date 3/27/2027
Facility Type Physician Office
Lab Director SANJAY PETHKAR

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