14D2188694 CLIA NUMBER - HARIS MEDICAL GROUP L L C KIDNEY CONSULTANTS

Laboratory Demographics

  • CLIA Code: 14D2188694
  • Facility Name: HARIS MEDICAL GROUP L L C KIDNEY CONSULTANTS
  • Facility Address: 1252 OGDEN AVE - STE B
    DOWNERS GROVE, IL
    ZIP 60515
  • Facility Phone: 630 876-9000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MOHAMMAD VASEEMUDDIN
  • NPI Number: 1710352091
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2188694
LAB Type Physician Office
Facility Name HARIS MEDICAL GROUP L L C KIDNEY CONSULTANTS
Street 1252 OGDEN AVE - STE B
City DOWNERS GROVE
State IL
ZIP 60515
Phone 630 876-9000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/21/2024
Certificate Expiration Date 7/20/2026
Facility Type Physician Office
Lab Director MOHAMMAD VASEEMUDDIN

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