MEDICARE: CLEAR LABS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1447918339
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEAR LABS LLC

Provider Business Mailing Address
First Line	:	6318 N CICERO AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60646-4422
Country	:	US
Telephone Number	:	872-985-7367
Fax Number	:

Provider Business Practice Location Address
First Line	:	6318 N CICERO AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60646-4422
Country	:	US
Telephone Number	:	872-985-7367
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	UNKNOWN MIR SAJID ALI SUFIYAN
Credential	:
Telephone Number	:	872-985-7367

Provider Enumeration Date	:	12/08/2021
Last Update Date	:	02/06/2024

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Directions to “CLEAR LABS LLC ” Practice Location

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