14D0417692 CLIA NUMBER - LAWRENCE E LEVINE MD

Laboratory Demographics

  • CLIA Code: 14D0417692
  • Facility Name: LAWRENCE E LEVINE MD
  • Facility Address: 800 AUSTIN EAST TOWER #460
    EVANSTON, IL
    ZIP 60202
  • Facility Phone: 847 864-0370
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: LAWRENCE E. LEVINE
  • NPI Number: 1538225560
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 14D0417692
LAB Type Physician Office
Facility Name LAWRENCE E LEVINE MD
Street 800 AUSTIN EAST TOWER #460
City EVANSTON
State IL
ZIP 60202
Phone 847 864-0370
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director LAWRENCE E. LEVINE

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