14D2213411 CLIA NUMBER - METRO NORTH SURGICAL CENTER

Laboratory Demographics

  • CLIA Code: 14D2213411
  • Facility Name: METRO NORTH SURGICAL CENTER
  • Facility Address: 2649 N LARAMIE AVE
    CHICAGO, IL
    ZIP 60639
  • Facility Phone: 773 373-0062
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: SHOEB A. MOHIUDDIN
  • NPI Number: 1508464074
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2213411
LAB Type Practitioner Other
Facility Name METRO NORTH SURGICAL CENTER
Street 2649 N LARAMIE AVE
City CHICAGO
State IL
ZIP 60639
Phone 773 373-0062
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/12/2025
Certificate Expiration Date 2/11/2027
Facility Type Practitioner Other
Lab Director SHOEB A. MOHIUDDIN

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