14D2086763 CLIA NUMBER - HEALINGSPACE LLC

Laboratory Demographics

  • CLIA Code: 14D2086763
  • Facility Name: HEALINGSPACE LLC
  • Facility Address: 2075 FOXFIELD RD, STE 102
    SAINT CHARLES, IL
    ZIP 60174
  • Facility Phone: 847 304-5526
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARILYN MITCHELL MD
  • NPI Number: 1316495534
  • Taxonomy: 207VG0400X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 14D2086763
LAB Type Physician Office
Facility Name HEALINGSPACE LLC
Street 2075 FOXFIELD RD, STE 102
City SAINT CHARLES
State IL
ZIP 60174
Phone 847 304-5526
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/12/2024
Certificate Expiration Date 11/11/2026
Facility Type Physician Office
Lab Director MARILYN MITCHELL MD

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