14D1023254 CLIA NUMBER - KEY INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 14D1023254
  • Facility Name: KEY INTERNAL MEDICINE
  • Facility Address: 100 PROVENA WAY - STE D
    BOURBONNAIS, IL
    ZIP 60914
  • Facility Phone: 815 932-9210
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DHARAM R. ANAND
  • NPI Number: 1447308176
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D1023254
LAB Type Physician Office
Facility Name KEY INTERNAL MEDICINE
Street 100 PROVENA WAY - STE D
City BOURBONNAIS
State IL
ZIP 60914
Phone 815 932-9210
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/11/2024
Certificate Expiration Date 3/10/2026
Facility Type Physician Office
Lab Director DHARAM R. ANAND

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