14D1080265 CLIA NUMBER - WOODRIDGE HOME DIALYSIS ROCKWOOD DIALYSIS L L C

Laboratory Demographics

  • CLIA Code: 14D1080265
  • Facility Name: WOODRIDGE HOME DIALYSIS ROCKWOOD DIALYSIS L L C
  • Facility Address: 7425 JANES AVE - STE 103
    WOODRIDGE, IL
    ZIP 60517
  • Facility Phone: 630 968-0081
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: MAZEN DIAB M D
  • NPI Number: 1629568555
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D1080265
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name WOODRIDGE HOME DIALYSIS ROCKWOOD DIALYSIS L L C
Street 7425 JANES AVE - STE 103
City WOODRIDGE
State IL
ZIP 60517
Phone 630 968-0081
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/19/2024
Certificate Expiration Date 2/18/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director MAZEN DIAB M D

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