14D2048982 CLIA NUMBER - LISLE INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 14D2048982
  • Facility Name: LISLE INTERNAL MEDICINE
  • Facility Address: 430 WARRENVILLE RD
    LISLE, IL
    ZIP 60532
  • Facility Phone: 630 432-6180
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JEAN M. HOULIHAN
  • NPI Number: 1912021783
  • Taxonomy: 251300000X - Local Education Agency (LEA)

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CLIA Record

Field Name Field Value
CLIA Number 14D2048982
LAB Type Physician Office
Facility Name LISLE INTERNAL MEDICINE
Street 430 WARRENVILLE RD
City LISLE
State IL
ZIP 60532
Phone 630 432-6180
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/26/2024
Certificate Expiration Date 10/25/2026
Facility Type Physician Office
Lab Director JEAN M. HOULIHAN

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