14D1047370 CLIA NUMBER - PRAIRIE POINT OBSTETRICS AND GYNECOLOGY

Laboratory Demographics

CLIA Number: 14D1047370

Facility Name: PRAIRIE POINT OBSTETRICS AND GYNECOLOGY

Facility Address:
BETHANY PROFESSIONAL BUILDING-SUITE C 1675 BETHANY ROAD
SYCAMORE, IL
ZIP 60178
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Facility Phone Number: 815 899-8080

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1841223070

Taxonomy: 207V00000X - Obstetrics & Gynecology
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

CLIA Record

Field Name	Field Value
CLIA Number	14D1047370
LAB Type	Physician Office
Facility Name	PRAIRIE POINT OBSTETRICS AND GYNECOLOGY
Street	BETHANY PROFESSIONAL BUILDING-SUITE C 1675 BETHANY ROAD
City	SYCAMORE
State	IL
ZIP	60178
Phone	815 899-8080
CertificateType	3
CertificateEffectiveDate	11/2/2023
CertificateExpirationDate	11/1/2025
FacilityType	PPMP

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