14D2251001 CLIA NUMBER - SKYLINE PHYSICIANS LLC

Laboratory Demographics

  • CLIA Code: 14D2251001
  • Facility Name: SKYLINE PHYSICIANS LLC
  • Facility Address: 1200 ROOSEVELR RD - STE 140
    GLEN ELLYN, IL
    ZIP 60137
  • Facility Phone: 630 423-3507
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAFAI A. BUKHARI
  • NPI Number: 1568704443
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2251001
LAB Type Physician Office
Facility Name SKYLINE PHYSICIANS LLC
Street 1200 ROOSEVELR RD - STE 140
City GLEN ELLYN
State IL
ZIP 60137
Phone 630 423-3507
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/31/2024
Certificate Expiration Date 1/30/2026
Facility Type Physician Office
Lab Director RAFAI A. BUKHARI

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