14D0982451 CLIA NUMBER - MERCY ALGONQUIN MEDICAL CENTER

Laboratory Demographics

CLIA Number: 14D0982451

Facility Name: MERCY ALGONQUIN MEDICAL CENTER

Facility Address:
2401 HARNISH DR - STE 101 PRAIRIE PROFESSIONAL CENTER
ALGONQUIN, IL
ZIP 60102
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Facility Phone Number: 847 458-5440

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1699847723

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	14D0982451
LAB Type	Physician Office
Facility Name	MERCY ALGONQUIN MEDICAL CENTER
Street	2401 HARNISH DR - STE 101 PRAIRIE PROFESSIONAL CENTER
City	ALGONQUIN
State	IL
ZIP	60102
Phone	847 458-5440
CertificateType	4
CertificateEffectiveDate	1/12/2024
CertificateExpirationDate	1/11/2026
FacilityType	Waiver

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