14D2267461 CLIA NUMBER - SOLLEY'S MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 14D2267461
  • Facility Name: SOLLEY'S MEDICAL GROUP
  • Facility Address: 4239 W 95TH ST
    OAK LAWN, IL
    ZIP 60453
  • Facility Phone: 708 529-0188
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: THEODORE GUS JAMES
  • NPI Number: 1487238390
  • Taxonomy: 101YA0400X - Counselor

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CLIA Record

Field Name Field Value
CLIA Number 14D2267461
LAB Type Ancillary Testing Site in Health Care Center
Facility Name SOLLEY'S MEDICAL GROUP
Street 4239 W 95TH ST
City OAK LAWN
State IL
ZIP 60453
Phone 708 529-0188
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/25/2024
Certificate Expiration Date 8/24/2026
Facility Type Ancillary Testing Site in Health Care Center
Lab Director THEODORE GUS JAMES

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