14D0940842 CLIA NUMBER - LAWRENCE L JOHNSON MD SC

Laboratory Demographics

  • CLIA Code: 14D0940842
  • Facility Name: LAWRENCE L JOHNSON MD SC
  • Facility Address: 3310 W MAIN ST, STE 115
    SAINT CHARLES, IL
    ZIP 60175
  • Facility Phone: 630 232-2885
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: LAWRENCE L. JOHNSON MD
  • NPI Number: 1114015351
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 14D0940842
LAB Type Physician Office
Facility Name LAWRENCE L JOHNSON MD SC
Street 3310 W MAIN ST, STE 115
City SAINT CHARLES
State IL
ZIP 60175
Phone 630 232-2885
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 2/18/2024
Certificate Expiration Date 2/17/2026
Facility Type Physician Office
Lab Director LAWRENCE L. JOHNSON MD

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