14D2017350 CLIA NUMBER - MOHAMMAD RAZZAQUE MD

Laboratory Demographics

  • CLIA Code: 14D2017350
  • Facility Name: MOHAMMAD RAZZAQUE MD
  • Facility Address: 3228 W 95TH ST
    EVERGREEN PARK, IL
    ZIP 60805
  • Facility Phone: (708) 425-4800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LORRAINE RAZIK
  • NPI Number: 1184683849
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2017350
LAB Type Physician Office
Facility Name MOHAMMAD RAZZAQUE MD
Street 3228 W 95TH ST
City EVERGREEN PARK
State IL
ZIP 60805
Phone 7084254800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/9/2024
Certificate Expiration Date 12/8/2026
Facility Type Physician Office
Lab Director LORRAINE RAZIK

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This page was last updated on: 5/18/2026