14D1044235 CLIA NUMBER - M J MEDICAL GROUP SC

Laboratory Demographics

  • CLIA Code: 14D1044235
  • Facility Name: M J MEDICAL GROUP SC
  • Facility Address: 6326 N LINCOLN AVE
    CHICAGO, IL
    ZIP 60659
  • Facility Phone: 773 463-4100
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL JUTOVSKY
  • NPI Number: 1780356725
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 14D1044235
LAB Type Physician Office
Facility Name M J MEDICAL GROUP SC
Street 6326 N LINCOLN AVE
City CHICAGO
State IL
ZIP 60659
Phone 773 463-4100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/15/2025
Certificate Expiration Date 8/14/2027
Facility Type Physician Office
Lab Director MICHAEL JUTOVSKY

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