14D1036164 CLIA NUMBER - TERENCE P SULLIVAN MD SC

Laboratory Demographics

  • CLIA Code: 14D1036164
  • Facility Name: TERENCE P SULLIVAN MD SC
  • Facility Address: 200 S MICHIGAN AVE-SUITE 830
    CHICAGO, IL
    ZIP 60604
  • Facility Phone: 312 922-2500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TERENCE P. SULLIVAN
  • NPI Number: 1073571584
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D1036164
LAB Type Physician Office
Facility Name TERENCE P SULLIVAN MD SC
Street 200 S MICHIGAN AVE-SUITE 830
City CHICAGO
State IL
ZIP 60604
Phone 312 922-2500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/24/2025
Certificate Expiration Date 1/23/2027
Facility Type Physician Office
Lab Director TERENCE P. SULLIVAN

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