14D1054877 CLIA NUMBER - BOZENA SCIGACZ MEDICAL OFFICE S C

Laboratory Demographics

  • CLIA Code: 14D1054877
  • Facility Name: BOZENA SCIGACZ MEDICAL OFFICE S C
  • Facility Address: 28 W LAKE STREET, SUITE 2
    ADDISON, IL
    ZIP 60101
  • Facility Phone: 630 458-0688
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: BOZENA E. SCIGACZ, MD
  • NPI Number: 1053365577
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D1054877
LAB Type Physician Office
Facility Name BOZENA SCIGACZ MEDICAL OFFICE S C
Street 28 W LAKE STREET, SUITE 2
City ADDISON
State IL
ZIP 60101
Phone 630 458-0688
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 6/2/2024
Certificate Expiration Date 6/1/2026
Facility Type Physician Office
Lab Director BOZENA E. SCIGACZ, MD

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