MEDICARE LABORATORY SERVICES LLC
NPI 1780356725
Clinical Medical Laboratory in Chicago, IL

NPI Status: Active since September 29, 2021

Contact Information

5659 N LINCOLN AVE
CHICAGO, IL
ZIP 60659
Phone: (773) 414-9035

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  • Organization
  • Clinical Medical Laboratory
  • CLIA Number: 14D1044235
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 08-14-2027

About MEDICARE LABORATORY SERVICES LLC

This page provides the complete NPI Profile along with additional information for Medicare Laboratory Services Llc, a provider established in Chicago, Illinois operating as a Clinical Medical Laboratory. The healthcare provider is registered in the NPI registry with number 1780356725 assigned on September 2021. The practitioner's primary taxonomy code is 291U00000X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The authorized official of this NPI record is Ayesha Khan (President)

NPI
1780356725
Provider Name
MEDICARE LABORATORY SERVICES LLC
Entity Type
Organization
Location Address
5659 N LINCOLN AVE CHICAGO, IL 60659
Location Phone
(773) 414-9035
Mailing Address
5659 N LINCOLN AVE CHICAGO, IL 60659
Mailing Phone
(773) 414-9035
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
09-29-2021
Last Update Date
04-05-2022
Code Navigator

Establishments like Medicare Laboratory Services Llc are healthcare facilities that may perform a wide range of laboratory procedures, assisted by doctors and medical technologists. Laboratories can be categorized according to their function as common diagnostic labs or specialty labs that conduct specialized or confirmatory tests. Different clinical laboratories could specialize in clinical chemistry, clinical microbiology, hematology, serology, clinical microscopy, cytopathology, molecular biology, or public health. Please inquire directly with this provider to confirm their test menu.

Clinical labs in the U.S. that perform human testing are regulated by the Centers for Medicare & Medicaid Services (CMS) through the Clinical Laboratory Improvement Amendments (CLIA) program. The purpose of the CLIA program is to guarantee the quality of laboratory testing. This provider has a CLIA number assigned, and undergoes regular inspections to ensure compliance and quality.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinical Medical Laboratory

Taxonomy Code
291U00000X
Type
Laboratories
Taxonomy Description
(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

AYESHA KHAN

Authorized Official Title
PRESIDENT
Authorized Official Phone
(773) 414-9035

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19)

This is a test to detect COVID-19, the virus causing severe respiratory illness. It uses a method called immunoassay, which identifies the virus by its unique proteins. The test is directly observed for accuracy. It helps determine if you're currently infected.

This service was performed 5,480 times for 535 patients

Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within

This is a test to detect the COVID-19 virus. It uses a technique that amplifies the virus's genetic material (DNA or RNA) for detection. High throughput technologies are used for rapid and large-scale testing. The procedure is completed within a set time frame.

This service was performed 8,403 times for 604 patients

Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r

This is a test for COVID-19. It uses high-tech methods to find the virus's genetic material in your body. The amplified probe technique helps detect the virus even in small amounts. This is crucial for early detection and effective treatment.

This service was performed 8,455 times for 604 patients

Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source

Specimen collection for SARS-CoV-2, the virus causing COVID-19, involves taking a sample from the nose or throat using a swab. This sample is then analyzed in a lab to detect the presence of the virus. It's a crucial step in diagnosing COVID-19.

This service was performed 13,899 times for 604 patients

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
14D1044235
Facility Type
Physician Office
Certificate Effective Date
August 15, 2025
Certificate Expiration Date
August 14, 2027
Laboratory Director
MICHAEL JUTOVSKY
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Medicare Laboratory Services Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1780356725, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
8
Doubled → 16 → 1 + 6
Pos 4
0
Unchanged
Pos 5
3
Doubled → 6
Pos 6
5
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
7
Unchanged
Pos 9
2
Doubled → 4
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 8 → 16 → 7 3 → 6 6 → 12 → 3 2 → 4

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 1 + 6 + 0 + 6 + 5 + 1 + 2 + 7 + 4 + 24 = 65

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 65 is 70. The difference is the calculated check digit.

70 - 65 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1780356725.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1780356725, enumerated as an "organization" on September 29, 2021.

The provider is located at 5659 N LINCOLN AVE CHICAGO, IL 60659 and the phone number is (773) 414-9035.

Clinical Medical Laboratory with taxonomy code 291U00000X.