14D0911455 CLIA NUMBER - AVANTARA LONG GROVE

Laboratory Demographics

  • CLIA Code: 14D0911455
  • Facility Name: AVANTARA LONG GROVE
  • Facility Address: 1666 CHECKER RD
    LONG GROVE, IL
    ZIP 60047
  • Facility Phone: 847 989-5883
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: JAMES R. FARLEE
  • NPI Number: 1598188237
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 14D0911455
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name AVANTARA LONG GROVE
Street 1666 CHECKER RD
City LONG GROVE
State IL
ZIP 60047
Phone 847 989-5883
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/6/2024
Certificate Expiration Date 2/5/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director JAMES R. FARLEE

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