14D2241320 CLIA NUMBER - FGM PEDIATRICS

Laboratory Demographics

  • CLIA Code: 14D2241320
  • Facility Name: FGM PEDIATRICS
  • Facility Address: 8711 W CERMAK RD
    NORTH RIVERSIDE, IL
    ZIP 60546
  • Facility Phone: 708 442-7979
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MARC FREED
  • NPI Number: 1780633313
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 14D2241320
LAB Type Physician Office
Facility Name FGM PEDIATRICS
Street 8711 W CERMAK RD
City NORTH RIVERSIDE
State IL
ZIP 60546
Phone 708 442-7979
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 10/27/2023
Certificate Expiration Date 10/26/2025
Facility Type Physician Office
Lab Director MARC FREED

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