14D1002133 CLIA NUMBER - RUSH-COPLEY MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 14D1002133
  • Facility Name: RUSH-COPLEY MEDICAL GROUP
  • Facility Address: 2972 INDIAN TRAIL RD
    AURORA, IL
    ZIP 60502
  • Facility Phone: 630 499-0812
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: PATRICIA KINSELLA-STALLTER DO
  • NPI Number: 1194836247
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D1002133
LAB Type Physician Office
Facility Name RUSH-COPLEY MEDICAL GROUP
Street 2972 INDIAN TRAIL RD
City AURORA
State IL
ZIP 60502
Phone 630 499-0812
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 7/30/2024
Certificate Expiration Date 7/29/2026
Facility Type Physician Office
Lab Director PATRICIA KINSELLA-STALLTER DO

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