14D2245909 CLIA NUMBER - IL DIAGNOSTIC CORP

Laboratory Demographics

  • CLIA Code: 14D2245909
  • Facility Name: IL DIAGNOSTIC CORP
  • Facility Address: 1580 N NORTHWEST HWY - STE 6
    PARK RIDGE, IL
    ZIP 60068
  • Facility Phone: 312 709-1532
  • Facility Type: Independent
  • Facility Type: Certificate of Compliance
  • Lab Director: MUHAMMAD SIDDIQUE KHURRAM
  • NPI Number: 1457078784
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 14D2245909
LAB Type Independent
Facility Name IL DIAGNOSTIC CORP
Street 1580 N NORTHWEST HWY - STE 6
City PARK RIDGE
State IL
ZIP 60068
Phone 312 709-1532
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 10/29/2024
Certificate Expiration Date 10/28/2026
Facility Type Independent
Lab Director MUHAMMAD SIDDIQUE KHURRAM

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This page was last updated on: 3/20/2025