14D1077359 CLIA NUMBER - LIFE MEDICAL S C

Laboratory Demographics

  • CLIA Code: 14D1077359
  • Facility Name: LIFE MEDICAL S C
  • Facility Address: 1550 NORTHWEST HWY, STE 209
    PARK RIDGE, IL
    ZIP 60068
  • Facility Phone: 847 653-8413
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAROSLAW R. LESZCZAK M D
  • NPI Number: 1245362847
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D1077359
LAB Type Physician Office
Facility Name LIFE MEDICAL S C
Street 1550 NORTHWEST HWY, STE 209
City PARK RIDGE
State IL
ZIP 60068
Phone 847 653-8413
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/7/2023
Certificate Expiration Date 12/6/2025
Facility Type Physician Office
Lab Director JAROSLAW R. LESZCZAK M D

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