14D2060963 CLIA NUMBER - AB DERMATOLOGY LLC

Laboratory Demographics

  • CLIA Code: 14D2060963
  • Facility Name: AB DERMATOLOGY LLC
  • Facility Address: 159 S BLOOMINGDALE RD
    BLOOMINGDALE, IL
    ZIP 60108
  • Facility Phone: 630 529-5950
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: SULEMAN J. BANGASH DO
  • NPI Number: 1629478714
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 14D2060963
LAB Type Physician Office
Facility Name AB DERMATOLOGY LLC
Street 159 S BLOOMINGDALE RD
City BLOOMINGDALE
State IL
ZIP 60108
Phone 630 529-5950
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 11/17/2023
Certificate Expiration Date 11/16/2025
Facility Type Physician Office
Lab Director SULEMAN J. BANGASH DO

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