14D2019155 CLIA NUMBER - STREETERVILLE INTERNAL MEDICINE LLC

Laboratory Demographics

  • CLIA Code: 14D2019155
  • Facility Name: STREETERVILLE INTERNAL MEDICINE LLC
  • Facility Address: 676 N SAINT CLAIR ST, STE 1740
    CHICAGO, IL
    ZIP 60611
  • Facility Phone: 312 926-0444
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. RACHEL A. OMARA
  • NPI Number: 1053684852
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2019155
LAB Type Physician Office
Facility Name STREETERVILLE INTERNAL MEDICINE LLC
Street 676 N SAINT CLAIR ST, STE 1740
City CHICAGO
State IL
ZIP 60611
Phone 312 926-0444
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 1/24/2025
Certificate Expiration Date 1/23/2027
Facility Type Physician Office
Lab Director DR. RACHEL A. OMARA

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