14D2058346 CLIA NUMBER - DONG S KIM M D S C

Laboratory Demographics

  • CLIA Code: 14D2058346
  • Facility Name: DONG S KIM M D S C
  • Facility Address: 4709 GOLF RD, STE 812
    SKOKIE, IL
    ZIP 60076
  • Facility Phone: 847 410-8442
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DONG S. KIM
  • NPI Number: 1255307104
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2058346
LAB Type Physician Office
Facility Name DONG S KIM M D S C
Street 4709 GOLF RD, STE 812
City SKOKIE
State IL
ZIP 60076
Phone 847 410-8442
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/6/2025
Certificate Expiration Date 5/5/2027
Facility Type Physician Office
Lab Director DONG S. KIM

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