14D2299904 CLIA NUMBER - OPULENT LUX LAB

Laboratory Demographics

  • CLIA Code: 14D2299904
  • Facility Name: OPULENT LUX LAB
  • Facility Address: 930 E 162ND ST - STE 1033
    SOUTH HOLLAND, IL
    ZIP 60473
  • Facility Phone: 708 200-8675
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: PAMELA JAMES
  • NPI Number: 1710676515
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D2299904
LAB Type Mobile Laboratory
Facility Name OPULENT LUX LAB
Street 930 E 162ND ST - STE 1033
City SOUTH HOLLAND
State IL
ZIP 60473
Phone 708 200-8675
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/28/2024
Certificate Expiration Date 2/27/2026
Facility Type Mobile Laboratory
Lab Director PAMELA JAMES

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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