14D0707039 CLIA NUMBER - NORTHWESTERN INTERNISTS LTD

Laboratory Demographics

  • CLIA Code: 14D0707039
  • Facility Name: NORTHWESTERN INTERNISTS LTD
  • Facility Address: 676 N ST CLAIR SUITE 415
    CHICAGO, IL
    ZIP 60611
  • Facility Phone: 312 335-1133
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: BETH E. ROYSTON, MD
  • NPI Number: 1891709259
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D0707039
LAB Type Physician Office
Facility Name NORTHWESTERN INTERNISTS LTD
Street 676 N ST CLAIR SUITE 415
City CHICAGO
State IL
ZIP 60611
Phone 312 335-1133
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 4/7/2024
Certificate Expiration Date 4/6/2026
Facility Type Physician Office
Lab Director BETH E. ROYSTON, MD

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