14D2296481 CLIA NUMBER - MIDWEST PRIMARY CARE & GERIATRICS

Laboratory Demographics

  • CLIA Code: 14D2296481
  • Facility Name: MIDWEST PRIMARY CARE & GERIATRICS
  • Facility Address: 1440 MAPLE AVE - STE 4A
    LISLE, IL
    ZIP 60532
  • Facility Phone: 630 344-7152
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NAUSHEEN AHMED
  • NPI Number: 1356074264
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2296481
LAB Type Physician Office
Facility Name MIDWEST PRIMARY CARE & GERIATRICS
Street 1440 MAPLE AVE - STE 4A
City LISLE
State IL
ZIP 60532
Phone 630 344-7152
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/29/2023
Certificate Expiration Date 12/28/2025
Facility Type Physician Office
Lab Director NAUSHEEN AHMED

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