14D2163642 CLIA NUMBER - PRIME MEDICAL IMAGING, L L C

Laboratory Demographics

  • CLIA Code: 14D2163642
  • Facility Name: PRIME MEDICAL IMAGING, L L C
  • Facility Address: 10260 W 191ST - STE 106
    MOKENA, IL
    ZIP 60448
  • Facility Phone: (847) 929-5460
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: RICHARD KIM M D
  • NPI Number: 1962974527
  • Taxonomy: 293D00000X - Physiological Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 14D2163642
LAB Type Independent
Facility Name PRIME MEDICAL IMAGING, L L C
Street 10260 W 191ST - STE 106
City MOKENA
State IL
ZIP 60448
Phone 8479295460
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/19/2025
Certificate Expiration Date 3/18/2027
Facility Type Independent
Lab Director RICHARD KIM M D

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This page was last updated on: 5/18/2026