14D0419103 CLIA NUMBER - PRESENCE MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 14D0419103
  • Facility Name: PRESENCE MEDICAL GROUP
  • Facility Address: 301 N MADISON ST, STE 210
    JOLIET, IL
    ZIP 60435
  • Facility Phone: 847 493-5336
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JONETTE BELICENA MD
  • NPI Number: 1659740033
  • Taxonomy: 2080P0205X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 14D0419103
LAB Type Physician Office
Facility Name PRESENCE MEDICAL GROUP
Street 301 N MADISON ST, STE 210
City JOLIET
State IL
ZIP 60435
Phone 847 493-5336
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 JONETTE BELICENA MD

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