14D2252105 CLIA NUMBER - MS LABORATORY

Laboratory Demographics

  • CLIA Code: 14D2252105
  • Facility Name: MS LABORATORY
  • Facility Address: 5901 N CICERO - STE 607
    CHICAGO, IL
    ZIP 60646
  • Facility Phone: 773 337-8555
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: NICOLE MCCULLOUGH
  • NPI Number: 1255086419
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 14D2252105
LAB Type Mobile Laboratory
Facility Name MS LABORATORY
Street 5901 N CICERO - STE 607
City CHICAGO
State IL
ZIP 60646
Phone 773 337-8555
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/2/2025
Certificate Expiration Date 1/1/2027
Facility Type Mobile Laboratory
Lab Director NICOLE MCCULLOUGH

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