14D0419399 CLIA NUMBER - BOLINGBROOK FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 14D0419399
  • Facility Name: BOLINGBROOK FAMILY MEDICINE
  • Facility Address: 329 REMINGTON BLVD - STE 200
    BOLINGBROOK, IL
    ZIP 60440
  • Facility Phone: 224 273-4000
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: CHRISTINE SHIH M D
  • NPI Number: 1275739518
  • Taxonomy: 207WX0107X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 14D0419399
LAB Type Physician Office
Facility Name BOLINGBROOK FAMILY MEDICINE
Street 329 REMINGTON BLVD - STE 200
City BOLINGBROOK
State IL
ZIP 60440
Phone 224 273-4000
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 7/2/2024
Certificate Expiration Date 7/1/2026
Facility Type Physician Office
Lab Director CHRISTINE SHIH M D

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