14D1024833 CLIA NUMBER - MED-PEDS SPECIALISTS SC

Laboratory Demographics

  • CLIA Code: 14D1024833
  • Facility Name: MED-PEDS SPECIALISTS SC
  • Facility Address: 15614 S HARLEM AVE-SUITE D
    ORLAND PARK, IL
    ZIP 60462
  • Facility Phone: 708 444-0097
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TOM CWIKLA
  • NPI Number: 1790848877
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D1024833
LAB Type Physician Office
Facility Name MED-PEDS SPECIALISTS SC
Street 15614 S HARLEM AVE-SUITE D
City ORLAND PARK
State IL
ZIP 60462
Phone 708 444-0097
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/22/2024
Certificate Expiration Date 4/21/2026
Facility Type Physician Office
Lab Director TOM CWIKLA

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