14D0856709 CLIA NUMBER - NORTHWESTERN MED REGIONAL MED GROUP - MULTI-SPEC

Laboratory Demographics

CLIA Number: 14D0856709

Facility Name: NORTHWESTERN MED REGIONAL MED GROUP - MULTI-SPEC

Facility Address:
233 S GARY AVE
BLOOMINGDALE, IL
ZIP 60108
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Facility Phone Number: (630) 924-4009

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1437271863

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	14D0856709
LAB Type	PHYSICIAN OFFICE
Facility Name	NORTHWESTERN MED REGIONAL MED GROUP - MULTI-SPEC
Street	233 S GARY AVE
City	BLOOMINGDALE
State	IL
ZIP	60108
Phone	(630) 924-4009

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This page was last updated on: 5/11/2023