14D2246621 CLIA NUMBER - SOUTHWEST LAB CORP

Laboratory Demographics

  • CLIA Code: 14D2246621
  • Facility Name: SOUTHWEST LAB CORP
  • Facility Address: 1960 SWANSON COURT, SUITE C1
    GURNEE, IL
    ZIP 60031
  • Facility Phone: 773 991-8205
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: AZEEM AYOOB
  • NPI Number: 1134872500
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 14D2246621
LAB Type Independent
Facility Name SOUTHWEST LAB CORP
Street 1960 SWANSON COURT, SUITE C1
City GURNEE
State IL
ZIP 60031
Phone 773 991-8205
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/17/2025
Certificate Expiration Date 5/16/2027
Facility Type Independent
Lab Director AZEEM AYOOB

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