14D1026709 CLIA NUMBER - WAJAHAT MIRZA MD SC

Laboratory Demographics

  • CLIA Code: 14D1026709
  • Facility Name: WAJAHAT MIRZA MD SC
  • Facility Address: 1170 E BELVIDERE RD - SUITE 212
    GRAYSLAKE, IL
    ZIP 60030
  • Facility Phone: 847 543-6814
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WAJAHAT MIRZA MD
  • NPI Number: 1245231570
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D1026709
LAB Type Physician Office
Facility Name WAJAHAT MIRZA MD SC
Street 1170 E BELVIDERE RD - SUITE 212
City GRAYSLAKE
State IL
ZIP 60030
Phone 847 543-6814
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/14/2024
Certificate Expiration Date 6/13/2026
Facility Type Physician Office
Lab Director WAJAHAT MIRZA MD

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