14D2312469 CLIA NUMBER - CENTER FOR MEDICAL DERMATOLOGY & IMMUNOLOGY RESEARCH

Laboratory Demographics

  • CLIA Code: 14D2312469
  • Facility Name: CENTER FOR MEDICAL DERMATOLOGY & IMMUNOLOGY RESEARCH
  • Facility Address: 3000 N HALSTED STREET SUITE 301
    CHICAGO, IL
    ZIP 60657
  • Facility Phone: 773 770-6372
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: RAJ CHOVATIYA
  • NPI Number: 1790230035
  • Taxonomy: 235Z00000X - Speech-Language Pathologist

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CLIA Record

Field Name Field Value
CLIA Number 14D2312469
LAB Type Independent
Facility Name CENTER FOR MEDICAL DERMATOLOGY & IMMUNOLOGY RESEARCH
Street 3000 N HALSTED STREET SUITE 301
City CHICAGO
State IL
ZIP 60657
Phone 773 770-6372
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/11/2024
Certificate Expiration Date 10/10/2026
Facility Type Independent
Lab Director RAJ CHOVATIYA

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