14D0412526 CLIA NUMBER - GLENVIEW PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 14D0412526
  • Facility Name: GLENVIEW PRIMARY CARE
  • Facility Address: 1435 WAUKEGAN ROAD
    GLENVIEW, IL
    ZIP 60025
  • Facility Phone: 847 832-6500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOHN REVIS M D
  • NPI Number: 1932233236
  • Taxonomy: 251300000X - Local Education Agency (LEA)

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CLIA Record

Field Name Field Value
CLIA Number 14D0412526
LAB Type Physician Office
Facility Name GLENVIEW PRIMARY CARE
Street 1435 WAUKEGAN ROAD
City GLENVIEW
State IL
ZIP 60025
Phone 847 832-6500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director JOHN REVIS M D

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