14D0421017 CLIA NUMBER - DULY HEATLH & CARE - DG MAIN PEDS

Laboratory Demographics

  • CLIA Code: 14D0421017
  • Facility Name: DULY HEATLH & CARE - DG MAIN PEDS
  • Facility Address: 5207 MAIN ST - STE 1A
    DOWNERS GROVE, IL
    ZIP 60515
  • Facility Phone: 630 964-6049
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL W. BOETTCHER MD
  • NPI Number: 1073010245
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 14D0421017
LAB Type Physician Office
Facility Name DULY HEATLH & CARE - DG MAIN PEDS
Street 5207 MAIN ST - STE 1A
City DOWNERS GROVE
State IL
ZIP 60515
Phone 630 964-6049
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/17/2025
Certificate Expiration Date 3/16/2027
Facility Type Physician Office
Lab Director MICHAEL W. BOETTCHER MD

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