14D2107761 CLIA NUMBER - MAYA MEDICAL CENTERS SC

Laboratory Demographics

  • CLIA Code: 14D2107761
  • Facility Name: MAYA MEDICAL CENTERS SC
  • Facility Address: 2955 WEST 95TH ST
    EVERGREEN PARK, IL
    ZIP 60805
  • Facility Phone: 708 422-1363
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: HAMDI M. KHILFEH MD
  • NPI Number: 1093974800
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 14D2107761
LAB Type Practitioner Other
Facility Name MAYA MEDICAL CENTERS SC
Street 2955 WEST 95TH ST
City EVERGREEN PARK
State IL
ZIP 60805
Phone 708 422-1363
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/21/2024
Certificate Expiration Date 1/20/2026
Facility Type Practitioner Other
Lab Director HAMDI M. KHILFEH MD

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