14D1076227 CLIA NUMBER - ADVOCATE MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 14D1076227
  • Facility Name: ADVOCATE MEDICAL GROUP
  • Facility Address: 1435 RANDALL RD, STE 310
    ELGIN, IL
    ZIP 60123
  • Facility Phone: 847 888-3661
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DOROTHEA POULOS
  • NPI Number: 1285745125
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D1076227
LAB Type Physician Office
Facility Name ADVOCATE MEDICAL GROUP
Street 1435 RANDALL RD, STE 310
City ELGIN
State IL
ZIP 60123
Phone 847 888-3661
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/8/2023
Certificate Expiration Date 11/7/2025
Facility Type Physician Office
Lab Director DOROTHEA POULOS

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