14D0421648 CLIA NUMBER - MARTINE NELSON MD

Laboratory Demographics

  • CLIA Code: 14D0421648
  • Facility Name: MARTINE NELSON MD
  • Facility Address: 2745 MAPLE AVE SUITE 2A
    LISLE, IL
    ZIP 60532
  • Facility Phone: 630 717-9600
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARTINE T. NELSON MD
  • NPI Number: 1669561478
  • Taxonomy: 2080A0000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 14D0421648
LAB Type Physician Office
Facility Name MARTINE NELSON MD
Street 2745 MAPLE AVE SUITE 2A
City LISLE
State IL
ZIP 60532
Phone 630 717-9600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/24/2024
Certificate Expiration Date 9/23/2026
Facility Type Physician Office
Lab Director MARTINE T. NELSON MD

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