14D2136922 CLIA NUMBER - SSD MEDICAL GROUP INC

Laboratory Demographics

  • CLIA Code: 14D2136922
  • Facility Name: SSD MEDICAL GROUP INC
  • Facility Address: 12151 REGENCY PARKWAY, SUITE 12165
    HUNTLEY, IL
    ZIP 60142
  • Facility Phone: 847 628-4751
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHAZIA S. DAUDI MD
  • NPI Number: 1932635083
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2136922
LAB Type Physician Office
Facility Name SSD MEDICAL GROUP INC
Street 12151 REGENCY PARKWAY, SUITE 12165
City HUNTLEY
State IL
ZIP 60142
Phone 847 628-4751
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/18/2025
Certificate Expiration Date 9/17/2027
Facility Type Physician Office
Lab Director SHAZIA S. DAUDI MD

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