14D0879925 CLIA NUMBER - HOWARD S MANGURTEN M D - S C

Laboratory Demographics

  • CLIA Code: 14D0879925
  • Facility Name: HOWARD S MANGURTEN M D - S C
  • Facility Address: 990 GRAND CANYON PARKWAY SUITE 310
    HOFFMAN ESTATES, IL
    ZIP 60169
  • Facility Phone: 847 884-8420
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: HOWARD S. MANGURTEN
  • NPI Number: 1003990870
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D0879925
LAB Type Physician Office
Facility Name HOWARD S MANGURTEN M D - S C
Street 990 GRAND CANYON PARKWAY SUITE 310
City HOFFMAN ESTATES
State IL
ZIP 60169
Phone 847 884-8420
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/3/2023
Certificate Expiration Date 12/2/2025
Facility Type Physician Office
Lab Director HOWARD S. MANGURTEN

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