14D0907979 CLIA NUMBER - DUPAGE MEDICAL GROUP - BARTLETT

Laboratory Demographics

CLIA Number: 14D0907979

Facility Name: DUPAGE MEDICAL GROUP - BARTLETT

Facility Address:
1124 STEARNS ROAD
BARTLETT, IL
ZIP 60103
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Facility Phone Number: 630 469-9200

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1275117145

Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

CLIA Record

Field Name	Field Value
CLIA Number	14D0907979
LAB Type	Physician Office
Facility Name	DUPAGE MEDICAL GROUP - BARTLETT
Street	1124 STEARNS ROAD
City	BARTLETT
State	IL
ZIP	60103
Phone	630 469-9200
CertificateType	3
CertificateEffectiveDate	10/26/2023
CertificateExpirationDate	10/25/2025
FacilityType	PPMP

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