14D1052767 CLIA NUMBER - RAJIV KANDALA

Laboratory Demographics

  • CLIA Code: 14D1052767
  • Facility Name: RAJIV KANDALA
  • Facility Address: 7531 S STONY ISLAND AVE, SUITE 164
    CHICAGO, IL
    ZIP 60649
  • Facility Phone: (773) 947-2831
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAJIV KANDALA
  • NPI Number: 1114094281
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D1052767
LAB Type Physician Office
Facility Name RAJIV KANDALA
Street 7531 S STONY ISLAND AVE, SUITE 164
City CHICAGO
State IL
ZIP 60649
Phone 7739472831
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/4/2026
Certificate Expiration Date 4/3/2028
Facility Type Physician Office
Lab Director RAJIV KANDALA

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This page was last updated on: 5/18/2026