14D2307985 CLIA NUMBER - ELITE PHYSICIANS MEDICAL GROUP INC

Laboratory Demographics

  • CLIA Code: 14D2307985
  • Facility Name: ELITE PHYSICIANS MEDICAL GROUP INC
  • Facility Address: 9634 S ROBERTS RD
    HICKORY HILLS, IL
    ZIP 60457
  • Facility Phone: (708) 380-8888
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ABDELKHALIQ I. QASEM
  • NPI Number: 1528802956
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2307985
LAB Type Physician Office
Facility Name ELITE PHYSICIANS MEDICAL GROUP INC
Street 9634 S ROBERTS RD
City HICKORY HILLS
State IL
ZIP 60457
Phone 7083808888
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/18/2024
Certificate Expiration Date 7/17/2026
Facility Type Physician Office
Lab Director ABDELKHALIQ I. QASEM

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This page was last updated on: 5/18/2026