14D2037551 CLIA NUMBER - GENESIS PEDIATRIC MEDICINE

Laboratory Demographics

  • CLIA Code: 14D2037551
  • Facility Name: GENESIS PEDIATRIC MEDICINE
  • Facility Address: 1680 MEDITERRANEAN DR
    SYCAMORE, IL
    ZIP 60178
  • Facility Phone: (815) 899-0001
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARK A. REGNIER
  • NPI Number: 1912295494
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 14D2037551
LAB Type Physician Office
Facility Name GENESIS PEDIATRIC MEDICINE
Street 1680 MEDITERRANEAN DR
City SYCAMORE
State IL
ZIP 60178
Phone 8158990001
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/1/2026
Certificate Expiration Date 2/29/2028
Facility Type Physician Office
Lab Director MARK A. REGNIER

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This page was last updated on: 5/18/2026