14D0875144 CLIA NUMBER - OB-GYNE ASSOCIATES OF LAKE FOREST, LTD

Laboratory Demographics

CLIA Number: 14D0875144

Facility Name: OB-GYNE ASSOCIATES OF LAKE FOREST, LTD

Facility Address:
959 S WAUKEGAN RD 2ND FLOOR
LAKE FOREST, IL
ZIP 60045
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Facility Phone Number: 847 234-3250

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1417093808

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	14D0875144
LAB Type	Physician Office
Facility Name	OB-GYNE ASSOCIATES OF LAKE FOREST, LTD
Street	959 S WAUKEGAN RD 2ND FLOOR
City	LAKE FOREST
State	IL
ZIP	60045
Phone	847 234-3250
CertificateType	3
CertificateEffectiveDate	8/18/2023
CertificateExpirationDate	8/17/2025
FacilityType	PPMP

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