14D2146857 CLIA NUMBER - PREFERRED URGENT CARE L L C

Laboratory Demographics

  • CLIA Code: 14D2146857
  • Facility Name: PREFERRED URGENT CARE L L C
  • Facility Address: 4849 W FULLERTON AVE
    CHICAGO, IL
    ZIP 60639
  • Facility Phone: 773 309-6740
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NASER RUSTOM M D
  • NPI Number: 1881181055
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2146857
LAB Type Physician Office
Facility Name PREFERRED URGENT CARE L L C
Street 4849 W FULLERTON AVE
City CHICAGO
State IL
ZIP 60639
Phone 773 309-6740
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/6/2024
Certificate Expiration Date 4/5/2026
Facility Type Physician Office
Lab Director NASER RUSTOM M D

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