14D0871804 CLIA NUMBER - FAMILY CARE OF LAKE COUNTY

Laboratory Demographics

CLIA Number: 14D0871804

Facility Name: FAMILY CARE OF LAKE COUNTY

Facility Address:
500 PARK AVENUE, STE 104
LAKE VILLA, IL
ZIP 60046
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Facility Phone Number: 847 245-8700

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1861485658

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	14D0871804
LAB Type	Physician Office
Facility Name	FAMILY CARE OF LAKE COUNTY
Street	500 PARK AVENUE, STE 104
City	LAKE VILLA
State	IL
ZIP	60046
Phone	847 245-8700
CertificateType	4
CertificateEffectiveDate	11/10/2023
CertificateExpirationDate	11/9/2025
FacilityType	Waiver

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