14D1030529 CLIA NUMBER - SOUTHWEST NEPHROLOGY ASSOCIATES SC

Laboratory Demographics

  • CLIA Code: 14D1030529
  • Facility Name: SOUTHWEST NEPHROLOGY ASSOCIATES SC
  • Facility Address: 16605 S 107TH COURT
    ORLAND PARK, IL
    ZIP 60467
  • Facility Phone: 708 226-9860
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EJIKEME OBASI M D
  • NPI Number: 1457437899
  • Taxonomy: 2084P0800X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 14D1030529
LAB Type Physician Office
Facility Name SOUTHWEST NEPHROLOGY ASSOCIATES SC
Street 16605 S 107TH COURT
City ORLAND PARK
State IL
ZIP 60467
Phone 708 226-9860
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/8/2024
Certificate Expiration Date 9/7/2026
Facility Type Physician Office
Lab Director EJIKEME OBASI M D

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