14D2004238 CLIA NUMBER - PROHEALTH MEDICAL CENTER

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Laboratory Demographics

CLIA Number: 14D2004238

Facility Name: PROHEALTH MEDICAL CENTER

Facility Address:
2003 MONTGOMERY RD, STE 106
AURORA, IL
ZIP 60504
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Facility Phone Number: 708 890-9115

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1740512359

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	14D2004238
LAB Type	Physician Office
Facility Name	PROHEALTH MEDICAL CENTER
Street	2003 MONTGOMERY RD, STE 106
City	AURORA
State	IL
ZIP	60504
Phone	708 890-9115
CertificateType	4
CertificateEffectiveDate	3/1/2024
CertificateExpirationDate	2/28/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024