14D2170868 CLIA NUMBER - MELROSE PARK DIALYSIS

Laboratory Demographics

  • CLIA Code: 14D2170868
  • Facility Name: MELROSE PARK DIALYSIS
  • Facility Address: 1985 N MANNHEIM RD
    MELROSE PARK, IL
    ZIP 60160
  • Facility Phone: 708 343-3236
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: RAJANI KOSURI M D
  • NPI Number: 1578603023
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2170868
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name MELROSE PARK DIALYSIS
Street 1985 N MANNHEIM RD
City MELROSE PARK
State IL
ZIP 60160
Phone 708 343-3236
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/21/2025
Certificate Expiration Date 8/20/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director RAJANI KOSURI M D

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