14D2236532 CLIA NUMBER - NINVA MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 14D2236532
  • Facility Name: NINVA MEDICAL GROUP
  • Facility Address: 8780 W GOLF RD - STE 303
    NILES, IL
    ZIP 60714
  • Facility Phone: 847 813-6579
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DANY MAMOU
  • NPI Number: 1841963881
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2236532
LAB Type Physician Office
Facility Name NINVA MEDICAL GROUP
Street 8780 W GOLF RD - STE 303
City NILES
State IL
ZIP 60714
Phone 847 813-6579
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/17/2025
Certificate Expiration Date 9/16/2027
Facility Type Physician Office
Lab Director DANY MAMOU

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