14D2190204 CLIA NUMBER - EHTESHAM GHANI

Laboratory Demographics

  • CLIA Code: 14D2190204
  • Facility Name: EHTESHAM GHANI
  • Facility Address: 9223 OGDEN
    BROOKFIELD, IL
    ZIP 60513
  • Facility Phone: 708 485-4050
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EHTESHAM J. GHANI M D
  • NPI Number: 1316988397
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2190204
LAB Type Physician Office
Facility Name EHTESHAM GHANI
Street 9223 OGDEN
City BROOKFIELD
State IL
ZIP 60513
Phone 708 485-4050
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/11/2024
Certificate Expiration Date 8/10/2026
Facility Type Physician Office
Lab Director EHTESHAM J. GHANI M D

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