14D1096035 CLIA NUMBER - BOLING MEDICAL LLC

Laboratory Demographics

  • CLIA Code: 14D1096035
  • Facility Name: BOLING MEDICAL LLC
  • Facility Address: 899 SOUTH WEBER ROAD, SUITE G
    BOLINGBROOK, IL
    ZIP 60490
  • Facility Phone: 630 226-1800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SUMA KAKI
  • NPI Number: 1003019894
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D1096035
LAB Type Physician Office
Facility Name BOLING MEDICAL LLC
Street 899 SOUTH WEBER ROAD, SUITE G
City BOLINGBROOK
State IL
ZIP 60490
Phone 630 226-1800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/24/2025
Certificate Expiration Date 2/23/2027
Facility Type Physician Office
Lab Director SUMA KAKI

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