14D1000800 CLIA NUMBER - PRIMARY CARE WEST SC

Laboratory Demographics

  • CLIA Code: 14D1000800
  • Facility Name: PRIMARY CARE WEST SC
  • Facility Address: 1300 HIGHLAND AVE STE 10
    AURORA, IL
    ZIP 60506
  • Facility Phone: 630 897-9606
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DAVE P. MANTE
  • NPI Number: 1154478766
  • Taxonomy: 261QH0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D1000800
LAB Type Physician Office
Facility Name PRIMARY CARE WEST SC
Street 1300 HIGHLAND AVE STE 10
City AURORA
State IL
ZIP 60506
Phone 630 897-9606
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/28/2023
Certificate Expiration Date 10/27/2025
Facility Type Physician Office
Lab Director DAVE P. MANTE

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