14D1093858 CLIA NUMBER - STEPHEN J CLARK MD PC

Laboratory Demographics

  • CLIA Code: 14D1093858
  • Facility Name: STEPHEN J CLARK MD PC
  • Facility Address: 3021 FALLING WATERS BLVD, S-A
    LINDENHURST, IL
    ZIP 60046
  • Facility Phone: 847 356-9300
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STEPHEN J. CLARK
  • NPI Number: 1538123385
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D1093858
LAB Type Physician Office
Facility Name STEPHEN J CLARK MD PC
Street 3021 FALLING WATERS BLVD, S-A
City LINDENHURST
State IL
ZIP 60046
Phone 847 356-9300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/5/2025
Certificate Expiration Date 1/4/2027
Facility Type Physician Office
Lab Director STEPHEN J. CLARK

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This page was last updated on: 6/4/2025