14D0863903 CLIA NUMBER - NORTHWESTERN MEDICINE REGL MED GRP OB/GYNE

Laboratory Demographics

CLIA Number: 14D0863903

Facility Name: NORTHWESTERN MEDICINE REGL MED GRP OB/GYNE

Facility Address:
636 RAYMOND DR - STE 303
NAPERVILLE, IL
ZIP 60563
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Facility Phone Number: 630 653-4240

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1265606925

Taxonomy: 1223G0001X - Dentist
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

CLIA Record

Field Name	Field Value
CLIA Number	14D0863903
LAB Type	Physician Office
Facility Name	NORTHWESTERN MEDICINE REGL MED GRP OB/GYNE
Street	636 RAYMOND DR - STE 303
City	NAPERVILLE
State	IL
ZIP	60563
Phone	630 653-4240
CertificateType	3
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	PPMP

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This page was last updated on: 4/23/2024