14D0895698 CLIA NUMBER - ELM STREET PEDIATRICS

Laboratory Demographics

  • CLIA Code: 14D0895698
  • Facility Name: ELM STREET PEDIATRICS
  • Facility Address: 572 LINCOLN AVE
    WINNETKA, IL
    ZIP 60093
  • Facility Phone: 847 501-4040
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOSHUA D. LEVIN
  • NPI Number: 1033124714
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 14D0895698
LAB Type Physician Office
Facility Name ELM STREET PEDIATRICS
Street 572 LINCOLN AVE
City WINNETKA
State IL
ZIP 60093
Phone 847 501-4040
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/18/2023
Certificate Expiration Date 11/17/2025
Facility Type Physician Office
Lab Director JOSHUA D. LEVIN

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