14D2115248 CLIA NUMBER - ENDO-MED CLINIC SC

Laboratory Demographics

  • CLIA Code: 14D2115248
  • Facility Name: ENDO-MED CLINIC SC
  • Facility Address: 3033 W JEFFERSON ST #206
    JOLIET, IL
    ZIP 60435
  • Facility Phone: 815 730-3304
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WASSIM EL-HARAKE MD
  • NPI Number: 1538519251
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 14D2115248
LAB Type Physician Office
Facility Name ENDO-MED CLINIC SC
Street 3033 W JEFFERSON ST #206
City JOLIET
State IL
ZIP 60435
Phone 815 730-3304
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/1/2024
Certificate Expiration Date 6/30/2026
Facility Type Physician Office
Lab Director WASSIM EL-HARAKE MD

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