14D1018076 CLIA NUMBER - TED J JAGIELO M D ABFP

Laboratory Demographics

  • CLIA Code: 14D1018076
  • Facility Name: TED J JAGIELO M D ABFP
  • Facility Address: 7447 W TALCOTT AVE, SUITE 521
    CHICAGO, IL
    ZIP 60631
  • Facility Phone: 773 763-3300
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TED J. JAGIELO
  • NPI Number: 1437290905
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D1018076
LAB Type Physician Office
Facility Name TED J JAGIELO M D ABFP
Street 7447 W TALCOTT AVE, SUITE 521
City CHICAGO
State IL
ZIP 60631
Phone 773 763-3300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/14/2025
Certificate Expiration Date 10/13/2027
Facility Type Physician Office
Lab Director TED J. JAGIELO

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