14D2001108 CLIA NUMBER - CICERO PEDIATRICS

Laboratory Demographics

  • CLIA Code: 14D2001108
  • Facility Name: CICERO PEDIATRICS
  • Facility Address: 5307 W CERMAK RD
    CICERO, IL
    ZIP 60804
  • Facility Phone: 708 477-6700
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KHUDSIA IRFAN M D
  • NPI Number: 1003100942
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 14D2001108
LAB Type Physician Office
Facility Name CICERO PEDIATRICS
Street 5307 W CERMAK RD
City CICERO
State IL
ZIP 60804
Phone 708 477-6700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/2/2025
Certificate Expiration Date 6/1/2027
Facility Type Physician Office
Lab Director KHUDSIA IRFAN M D

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