14D1079340 CLIA NUMBER - MOHS SURGERY AND DERMATOLOGY CENTER

Laboratory Demographics

  • CLIA Code: 14D1079340
  • Facility Name: MOHS SURGERY AND DERMATOLOGY CENTER
  • Facility Address: 1750 N RANDALL RD, SUITE 120
    ELGIN, IL
    ZIP 60123
  • Facility Phone: 847 608-6647
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: SULEMAN J. BANGASH
  • NPI Number: 1356721591
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 14D1079340
LAB Type Physician Office
Facility Name MOHS SURGERY AND DERMATOLOGY CENTER
Street 1750 N RANDALL RD, SUITE 120
City ELGIN
State IL
ZIP 60123
Phone 847 608-6647
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 6/4/2024
Certificate Expiration Date 6/3/2026
Facility Type Physician Office
Lab Director SULEMAN J. BANGASH

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