14D2070959 CLIA NUMBER - MARCON MEDICAL PARTNER INC

Laboratory Demographics

  • CLIA Code: 14D2070959
  • Facility Name: MARCON MEDICAL PARTNER INC
  • Facility Address: 1140 N MC LEAN BLVD, UNIT C
    ELGIN, IL
    ZIP 60123
  • Facility Phone: 224 558-5493
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EUGENE TARASOV
  • NPI Number: 1114358017
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2070959
LAB Type Physician Office
Facility Name MARCON MEDICAL PARTNER INC
Street 1140 N MC LEAN BLVD, UNIT C
City ELGIN
State IL
ZIP 60123
Phone 224 558-5493
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/30/2023
Certificate Expiration Date 12/29/2025
Facility Type Physician Office
Lab Director EUGENE TARASOV

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