14D2220688 CLIA NUMBER - KIMBERLY BATTLE-MILLER, MD SC

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Laboratory Demographics

CLIA Number: 14D2220688

Facility Name: KIMBERLY BATTLE-MILLER, MD SC

Facility Address:
RICHTON PARK MEDICAL BUILDING 4511 SAUK TRAIL
RICHTON PARK, IL
ZIP 60471
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Facility Phone Number: 708 932-9351

Facility Type: Mobile Laboratory

Certificate Type: Waiver

NPI Number: 1669489712

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	14D2220688
LAB Type	Mobile Laboratory
Facility Name	KIMBERLY BATTLE-MILLER, MD SC
Street	RICHTON PARK MEDICAL BUILDING 4511 SAUK TRAIL
City	RICHTON PARK
State	IL
ZIP	60471
Phone	708 932-9351
CertificateType	4
CertificateEffectiveDate	4/14/2023
CertificateExpirationDate	4/13/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024