Active NPI
Clinical Diagnostic Labs LTD
- Clinical Medical Laboratory
- Skokie, IL
National Provider Identifier
1154294502
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- CLINICAL DIAGNOSTIC LABS LTD
- Practice address
- 4652 Oakton St
Skokie, IL 60076-3145 - Phone
- (708) 529-5659
- Fax
- (708) 529-5885
- NPI assigned
- Sep 23, 2025
- Last updated
- Aug 11, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ansar A Mohammed
- Title
- Authorized Official
- Phone
- (773) 852-7866
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | NU | Primary |
Addresses
Primary practice location
4652 Oakton St
Skokie, IL 60076-3145
Mailing address
4652 Oakton St
Skokie, IL 60076-3145
Phone (708) 529-5659
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14D2332681 | Other | IL | CLIA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20251119002469 | IL | Part B Supplier - Independent Clinical Laboratory | 6800387671 | Practice locations: Oakbrook Terrace, IL |
National Provider Directory
National Provider DirectoryLocations
1 Transam Plaza Dr
Ste 16B
Oakbrook Terrace, IL 60181
Phone (708) 529-5659
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Medical Laboratory Technician
- Chicago, IL
- NPI 1265194120
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1758585600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1786406400000",
"number": "1154294502",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4652 OAKTON ST",
"city": "SKOKIE",
"state": "IL",
"postal_code": "600763145",
"telephone_number": "708-529-5659",
"fax_number": "708-529-5885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4652 OAKTON ST",
"city": "SKOKIE",
"state": "IL",
"postal_code": "600763145",
"telephone_number": "708-529-5659",
"fax_number": "708-529-5885"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CLINICAL DIAGNOSTIC LABS LTD",
"organizational_subpart": "NO",
"enumeration_date": "2025-09-23",
"last_updated": "2026-08-11",
"certification_date": "2026-08-11",
"status": "A",
"authorized_official_last_name": "MOHAMMED",
"authorized_official_first_name": "ANSAR",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "773-852-7866"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLIA",
"identifier": "14D2332681",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
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- Clinical and Interventional Cardiology
- Clinician's Incubator LLC (Nutrition Hive)
- Laura Cloonan, MS CCC-SLP/L
- Angele Close, PHD.
- Troy Close, M.D.
- Clybourn Consulting Corporation
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.