14D2091499 CLIA NUMBER - ULTIMATE MEDICAL CARE PC

Laboratory Demographics

  • CLIA Code: 14D2091499
  • Facility Name: ULTIMATE MEDICAL CARE PC
  • Facility Address: 5600 WEST 87TH ST
    BURBANK, IL
    ZIP 60459
  • Facility Phone: 708 952-0000
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: STEVE ELMOSA
  • NPI Number: 1386047397
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2091499
LAB Type Practitioner Other
Facility Name ULTIMATE MEDICAL CARE PC
Street 5600 WEST 87TH ST
City BURBANK
State IL
ZIP 60459
Phone 708 952-0000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/13/2025
Certificate Expiration Date 2/12/2027
Facility Type Practitioner Other
Lab Director STEVE ELMOSA

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