14D2085889 CLIA NUMBER - MULLAPUDI MEDICAL/RAJENDRA MULLAPUDI MD

Laboratory Demographics

  • CLIA Code: 14D2085889
  • Facility Name: MULLAPUDI MEDICAL/RAJENDRA MULLAPUDI MD
  • Facility Address: 1505 W DEVON AVE
    CHICAGO, IL
    ZIP 60660
  • Facility Phone: 630 926-5409
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAJENDRA P. MULLAPUDI MD
  • NPI Number: 1811219017
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 14D2085889
LAB Type Physician Office
Facility Name MULLAPUDI MEDICAL/RAJENDRA MULLAPUDI MD
Street 1505 W DEVON AVE
City CHICAGO
State IL
ZIP 60660
Phone 630 926-5409
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/24/2024
Certificate Expiration Date 10/23/2026
Facility Type Physician Office
Lab Director RAJENDRA P. MULLAPUDI MD

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