14D2074128 CLIA NUMBER - COMPREHENSIVE WEIGHT MANAGEMENT CENTER L L C

Laboratory Demographics

  • CLIA Code: 14D2074128
  • Facility Name: COMPREHENSIVE WEIGHT MANAGEMENT CENTER L L C
  • Facility Address: 4747 LINCOLN MALL DR, STE 100
    MATTESON, IL
    ZIP 60443
  • Facility Phone: 708 747-8006
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHERRIFF A. ALLI-BALOGUN M D
  • NPI Number: 1144914730
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2074128
LAB Type Physician Office
Facility Name COMPREHENSIVE WEIGHT MANAGEMENT CENTER L L C
Street 4747 LINCOLN MALL DR, STE 100
City MATTESON
State IL
ZIP 60443
Phone 708 747-8006
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/3/2024
Certificate Expiration Date 3/2/2026
Facility Type Physician Office
Lab Director SHERRIFF A. ALLI-BALOGUN M D

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