14D2027593 CLIA NUMBER - PREMIER INTERNAL MEDICINE GROUP S C

Laboratory Demographics

  • CLIA Code: 14D2027593
  • Facility Name: PREMIER INTERNAL MEDICINE GROUP S C
  • Facility Address: 2910 S HARLEM AVE
    RIVERSIDE, IL
    ZIP 60546
  • Facility Phone: 708 447-4267
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TAHIR ROHAIL
  • NPI Number: 1194730713
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2027593
LAB Type Physician Office
Facility Name PREMIER INTERNAL MEDICINE GROUP S C
Street 2910 S HARLEM AVE
City RIVERSIDE
State IL
ZIP 60546
Phone 708 447-4267
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/27/2025
Certificate Expiration Date 7/26/2027
Facility Type Physician Office
Lab Director TAHIR ROHAIL

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