14D1069862 CLIA NUMBER - ELLIS J TALBERT MD SC

Laboratory Demographics

  • CLIA Code: 14D1069862
  • Facility Name: ELLIS J TALBERT MD SC
  • Facility Address: 7000 S ADAMS ST, STE 240
    WILLOWBROOK, IL
    ZIP 60527
  • Facility Phone: 630 986-5106
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ELLIS J. TALBERT
  • NPI Number: 1538257886
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D1069862
LAB Type Physician Office
Facility Name ELLIS J TALBERT MD SC
Street 7000 S ADAMS ST, STE 240
City WILLOWBROOK
State IL
ZIP 60527
Phone 630 986-5106
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/14/2025
Certificate Expiration Date 6/13/2027
Facility Type Physician Office
Lab Director ELLIS J. TALBERT

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