14D2292388 CLIA NUMBER - SUBURBAN MEDICAL GROUP CORP

Laboratory Demographics

  • CLIA Code: 14D2292388
  • Facility Name: SUBURBAN MEDICAL GROUP CORP
  • Facility Address: 200 N GARY AVE
    CAROL STREAM, IL
    ZIP 60188
  • Facility Phone: 630 360-2958
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MOHD MOHIUDDIN
  • NPI Number: 1134824410
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2292388
LAB Type Physician Office
Facility Name SUBURBAN MEDICAL GROUP CORP
Street 200 N GARY AVE
City CAROL STREAM
State IL
ZIP 60188
Phone 630 360-2958
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/25/2023
Certificate Expiration Date 10/24/2025
Facility Type Physician Office
Lab Director MOHD MOHIUDDIN

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