14D0896534 CLIA NUMBER - CHILDREN & TEENS MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 14D0896534
  • Facility Name: CHILDREN & TEENS MEDICAL CENTER
  • Facility Address: 620 SOUTH MAIN STREET
    ALGONQUIN, IL
    ZIP 60102
  • Facility Phone: 847 854-5900
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL R. ODONNELL MD
  • NPI Number: 1154597029
  • Taxonomy: 2084N0402X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 14D0896534
LAB Type Physician Office
Facility Name CHILDREN & TEENS MEDICAL CENTER
Street 620 SOUTH MAIN STREET
City ALGONQUIN
State IL
ZIP 60102
Phone 847 854-5900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/20/2025
Certificate Expiration Date 8/19/2027
Facility Type Physician Office
Lab Director MICHAEL R. ODONNELL MD

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