14D2000820 CLIA NUMBER - MATHERS CLINIC LLC

Laboratory Demographics

  • CLIA Code: 14D2000820
  • Facility Name: MATHERS CLINIC LLC
  • Facility Address: 145 S VIRGINIA ST
    CRYSTAL LAKE, IL
    ZIP 60014
  • Facility Phone: 815 397-7654
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAMESH B. VEMURI
  • NPI Number: 1215194519
  • Taxonomy: 2084P0804X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 14D2000820
LAB Type Physician Office
Facility Name MATHERS CLINIC LLC
Street 145 S VIRGINIA ST
City CRYSTAL LAKE
State IL
ZIP 60014
Phone 815 397-7654
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/7/2023
Certificate Expiration Date 12/6/2025
Facility Type Physician Office
Lab Director RAMESH B. VEMURI

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