14D1101418 CLIA NUMBER - MIDWAY PEDIATRICS L L C

Laboratory Demographics

  • CLIA Code: 14D1101418
  • Facility Name: MIDWAY PEDIATRICS L L C
  • Facility Address: 4254 W 55TH STREET
    CHICAGO, IL
    ZIP 60632
  • Facility Phone: 773 582-5200
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHELLE ROJAS
  • NPI Number: 1215373022
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 14D1101418
LAB Type Physician Office
Facility Name MIDWAY PEDIATRICS L L C
Street 4254 W 55TH STREET
City CHICAGO
State IL
ZIP 60632
Phone 773 582-5200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/26/2025
Certificate Expiration Date 6/25/2027
Facility Type Physician Office
Lab Director MICHELLE ROJAS

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