14D2163787 CLIA NUMBER - SCOTT J RUSCO, D O, INC (PRIVATE OFFICE)

Laboratory Demographics

  • CLIA Code: 14D2163787
  • Facility Name: SCOTT J RUSCO, D O, INC (PRIVATE OFFICE)
  • Facility Address: 6360 W 159TH ST - STE D & E
    OAK FOREST, IL
    ZIP 60452
  • Facility Phone: 708 535-6204
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SCOTT J. RUSCO
  • NPI Number: 1023050150
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2163787
LAB Type Physician Office
Facility Name SCOTT J RUSCO, D O, INC (PRIVATE OFFICE)
Street 6360 W 159TH ST - STE D & E
City OAK FOREST
State IL
ZIP 60452
Phone 708 535-6204
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/21/2025
Certificate Expiration Date 3/20/2027
Facility Type Physician Office
Lab Director SCOTT J. RUSCO

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