14D1077652 CLIA NUMBER - WOMEN FOR WOMEN THORNTON AND HAAS SC

Laboratory Demographics

  • CLIA Code: 14D1077652
  • Facility Name: WOMEN FOR WOMEN THORNTON AND HAAS SC
  • Facility Address: 1302 FRANKLIN AVENUE, SUITE 2200
    NORMAL, IL
    ZIP 61761
  • Facility Phone: 309 888-9900
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: SUSAN J. SVIENTEK
  • NPI Number: 1023120227
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 14D1077652
LAB Type Physician Office
Facility Name WOMEN FOR WOMEN THORNTON AND HAAS SC
Street 1302 FRANKLIN AVENUE, SUITE 2200
City NORMAL
State IL
ZIP 61761
Phone 309 888-9900
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 5/7/2024
Certificate Expiration Date 5/6/2026
Facility Type Physician Office
Lab Director SUSAN J. SVIENTEK

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