14D0936528 CLIA NUMBER - CENTRAL DUPAGE PHYSICIAN GROUP #112

Laboratory Demographics

  • CLIA Code: 14D0936528
  • Facility Name: CENTRAL DUPAGE PHYSICIAN GROUP #112
  • Facility Address: 7 BLANCHARD CIRCLE STE 206
    WHEATON, IL
    ZIP 60189
  • Facility Phone: 630 653-0848
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DOUGLAS L. AMBLER
  • NPI Number: 1750625117
  • Taxonomy: 207X00000X - Orthopaedic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 14D0936528
LAB Type Physician Office
Facility Name CENTRAL DUPAGE PHYSICIAN GROUP #112
Street 7 BLANCHARD CIRCLE STE 206
City WHEATON
State IL
ZIP 60189
Phone 630 653-0848
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/24/2023
Certificate Expiration Date 11/23/2025
Facility Type Physician Office
Lab Director DOUGLAS L. AMBLER

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