14D2044254 CLIA NUMBER - MARIO ROSAS M D S C

Laboratory Demographics

  • CLIA Code: 14D2044254
  • Facility Name: MARIO ROSAS M D S C
  • Facility Address: 2619 S LAWNDALE
    CHICAGO, IL
    ZIP 60623
  • Facility Phone: 773 522-2620
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARIO ROSAS M D
  • NPI Number: 1841369881
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2044254
LAB Type Physician Office
Facility Name MARIO ROSAS M D S C
Street 2619 S LAWNDALE
City CHICAGO
State IL
ZIP 60623
Phone 773 522-2620
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/19/2024
Certificate Expiration Date 7/18/2026
Facility Type Physician Office
Lab Director MARIO ROSAS M D

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