14D2026201 CLIA NUMBER - LEGACY MEDICAL CARE INC

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Laboratory Demographics

CLIA Number: 14D2026201

Facility Name: LEGACY MEDICAL CARE INC

Facility Address:
121 S WILKE RD, STE 605
ARLINGTON HEIGHTS, IL
ZIP 60005
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Facility Phone Number: 847 259-8379

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1497181697

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D2026201
LAB Type	Physician Office
Facility Name	LEGACY MEDICAL CARE INC
Street	121 S WILKE RD, STE 605
City	ARLINGTON HEIGHTS
State	IL
ZIP	60005
Phone	847 259-8379
CertificateType	3
CertificateEffectiveDate	6/27/2023
CertificateExpirationDate	6/26/2025
FacilityType	PPMP

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