14D2330537 CLIA NUMBER - MEDIVERSE PROFESSIONAL GROUP PLLC

Laboratory Demographics

  • CLIA Code: 14D2330537
  • Facility Name: MEDIVERSE PROFESSIONAL GROUP PLLC
  • Facility Address: 2210 MIDWEST RD
    OAK BROOK, IL
    ZIP 60523
  • Facility Phone: (630) 366-6186
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: USMAN QADEER
  • NPI Number: 1356275630
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 14D2330537
LAB Type Physician Office
Facility Name MEDIVERSE PROFESSIONAL GROUP PLLC
Street 2210 MIDWEST RD
City OAK BROOK
State IL
ZIP 60523
Phone 6303666186
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/17/2025
Certificate Expiration Date 9/16/2027
Facility Type Physician Office
Lab Director USMAN QADEER

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This page was last updated on: 6/29/2026