14D2223308 CLIA NUMBER - ASJ MD SC

Laboratory Demographics

  • CLIA Code: 14D2223308
  • Facility Name: ASJ MD SC
  • Facility Address: 6508 S HALSTED
    CHICAGO, IL
    ZIP 60621
  • Facility Phone: 773 651-1224
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANUJ JAIN M D
  • NPI Number: 1740776350
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2223308
LAB Type Physician Office
Facility Name ASJ MD SC
Street 6508 S HALSTED
City CHICAGO
State IL
ZIP 60621
Phone 773 651-1224
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/5/2025
Certificate Expiration Date 5/4/2027
Facility Type Physician Office
Lab Director ANUJ JAIN M D

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