14D2013792 CLIA NUMBER - DES PLAINES DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 14D2013792
  • Facility Name: DES PLAINES DERMATOLOGY
  • Facility Address: 1455 E GOLF RD, SGTE 104
    DES PLAINES, IL
    ZIP 60016
  • Facility Phone: 847 699-3101
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. JEANNE M. HOAG
  • NPI Number: 1194859975
  • Taxonomy: 251300000X - Local Education Agency (LEA)

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CLIA Record

Field Name Field Value
CLIA Number 14D2013792
LAB Type Physician Office
Facility Name DES PLAINES DERMATOLOGY
Street 1455 E GOLF RD, SGTE 104
City DES PLAINES
State IL
ZIP 60016
Phone 847 699-3101
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 9/24/2024
Certificate Expiration Date 9/23/2026
Facility Type Physician Office
Lab Director DR. JEANNE M. HOAG

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