14D1040200 CLIA NUMBER - PINNACLE DERMATOLOGY

Laboratory Demographics

CLIA Number: 14D1040200

Facility Name: PINNACLE DERMATOLOGY

Facility Address:
104 N HAVEN RD STE 7
ELMHURST, IL
ZIP 60126
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Facility Phone Number: 815 744-8554

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1134311251

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	14D1040200
LAB Type	Physician Office
Facility Name	PINNACLE DERMATOLOGY
Street	104 N HAVEN RD STE 7
City	ELMHURST
State	IL
ZIP	60126
Phone	815 744-8554
CertificateType	2
CertificateEffectiveDate	12/7/2021
CertificateExpirationDate	4/30/2024
FacilityType	Compliance

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