14D0993485 CLIA NUMBER - LEMONT PRIMARY CARE SC

Laboratory Demographics

  • CLIA Code: 14D0993485
  • Facility Name: LEMONT PRIMARY CARE SC
  • Facility Address: 15505 127TH STREET
    LEMONT, IL
    ZIP 60439
  • Facility Phone: 630 257-2265
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KENNETH B. PORTER
  • NPI Number: 1558477034
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D0993485
LAB Type Physician Office
Facility Name LEMONT PRIMARY CARE SC
Street 15505 127TH STREET
City LEMONT
State IL
ZIP 60439
Phone 630 257-2265
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/15/2023
Certificate Expiration Date 11/14/2025
Facility Type Physician Office
Lab Director KENNETH B. PORTER

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