14D2241321 CLIA NUMBER - STAT MOBILE PHLEBOTOMY LLC

Laboratory Demographics

  • CLIA Code: 14D2241321
  • Facility Name: STAT MOBILE PHLEBOTOMY LLC
  • Facility Address: 3202 7TH ST - STE 102
    PARK CITY, IL
    ZIP 60085
  • Facility Phone: 312 508-0530
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: JOHNOY ELLIOTT
  • NPI Number: 1659965887
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 14D2241321
LAB Type Mobile Laboratory
Facility Name STAT MOBILE PHLEBOTOMY LLC
Street 3202 7TH ST - STE 102
City PARK CITY
State IL
ZIP 60085
Phone 312 508-0530
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/27/2023
Certificate Expiration Date 10/26/2025
Facility Type Mobile Laboratory
Lab Director JOHNOY ELLIOTT

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