14D0423982 CLIA NUMBER - INTERNAL MEDICINE ASSOCIATES LLC

Laboratory Demographics

  • CLIA Code: 14D0423982
  • Facility Name: INTERNAL MEDICINE ASSOCIATES LLC
  • Facility Address: 676 N ST CLAIR ST - STE 510
    CHICAGO, IL
    ZIP 60611
  • Facility Phone: 312 944-0688
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MARY BETH RICHMOND M D
  • NPI Number: 1861558181
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D0423982
LAB Type Physician Office
Facility Name INTERNAL MEDICINE ASSOCIATES LLC
Street 676 N ST CLAIR ST - STE 510
City CHICAGO
State IL
ZIP 60611
Phone 312 944-0688
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 MARY BETH RICHMOND M D

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