14D2097752 CLIA NUMBER - SOUTH LOOP GI LABORATORY

Laboratory Demographics

  • CLIA Code: 14D2097752
  • Facility Name: SOUTH LOOP GI LABORATORY
  • Facility Address: 3744 W NORTH AVE SUITE 1
    CHICAGO, IL
    ZIP 60647
  • Facility Phone: 630 889-9889
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: SHIWEN SONG
  • NPI Number: 1144593369
  • Taxonomy: 261QE0800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2097752
LAB Type Physician Office
Facility Name SOUTH LOOP GI LABORATORY
Street 3744 W NORTH AVE SUITE 1
City CHICAGO
State IL
ZIP 60647
Phone 630 889-9889
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 3/29/2024
Certificate Expiration Date 3/28/2026
Facility Type Physician Office
Lab Director SHIWEN SONG

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