15D2101373 CLIA NUMBER - MIDWEST ORTHOPAEDICS AT RUSH, LLC

Laboratory Demographics

  • CLIA Code: 15D2101373
  • Facility Name: MIDWEST ORTHOPAEDICS AT RUSH, LLC
  • Facility Address: 9200 CALUMET AVE
    MUNSTER, IN
    ZIP 46321
  • Facility Phone: 708 236-2673
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LEDA GHANNAD
  • NPI Number: 1811942451
  • Taxonomy: 207X00000X - Orthopaedic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 15D2101373
LAB Type Physician Office
Facility Name MIDWEST ORTHOPAEDICS AT RUSH, LLC
Street 9200 CALUMET AVE
City MUNSTER
State IN
ZIP 46321
Phone 708 236-2673
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2025
Certificate Expiration Date 8/31/2027
Facility Type Physician Office
Lab Director LEDA GHANNAD

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