14D2110550 CLIA NUMBER - MARIANO'S #8536

Laboratory Demographics

  • CLIA Code: 14D2110550
  • Facility Name: MARIANO'S #8536
  • Facility Address: 150 WEST 63RD ST
    WESTMONT, IL
    ZIP 60559
  • Facility Phone: 630 964-4654
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MITA K. PATEL
  • NPI Number: 1386002145
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2110550
LAB Type Pharmacy
Facility Name MARIANO'S #8536
Street 150 WEST 63RD ST
City WESTMONT
State IL
ZIP 60559
Phone 630 964-4654
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/16/2024
Certificate Expiration Date 3/15/2026
Facility Type Pharmacy
Lab Director MITA K. PATEL

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