14D2258374 CLIA NUMBER - SUN MED LAB LLC

Laboratory Demographics

  • CLIA Code: 14D2258374
  • Facility Name: SUN MED LAB LLC
  • Facility Address: 7531 S STONY ISLAND AVE - STE 164
    CHICAGO, IL
    ZIP 60649
  • Facility Phone: 773 947-2831
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: RAJIV KANDALA
  • NPI Number: 1801533161
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2258374
LAB Type Independent
Facility Name SUN MED LAB LLC
Street 7531 S STONY ISLAND AVE - STE 164
City CHICAGO
State IL
ZIP 60649
Phone 773 947-2831
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/20/2024
Certificate Expiration Date 4/19/2026
Facility Type Independent
Lab Director RAJIV KANDALA

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