14D2089553 CLIA NUMBER - PEDIATRIC AND ADOLESCENT HEALTHY LIFESTYLE CTR

Laboratory Demographics

  • CLIA Code: 14D2089553
  • Facility Name: PEDIATRIC AND ADOLESCENT HEALTHY LIFESTYLE CTR
  • Facility Address: 2525 OGDEN AVE
    DOWNERS GROVE, IL
    ZIP 60515
  • Facility Phone: 630 929-3009
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MOROUNKEJI E. AKIN-OLUGBEMI
  • NPI Number: 1790989705
  • Taxonomy: 207W00000X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 14D2089553
LAB Type Physician Office
Facility Name PEDIATRIC AND ADOLESCENT HEALTHY LIFESTYLE CTR
Street 2525 OGDEN AVE
City DOWNERS GROVE
State IL
ZIP 60515
Phone 630 929-3009
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/5/2025
Certificate Expiration Date 1/4/2027
Facility Type Physician Office
Lab Director MOROUNKEJI E. AKIN-OLUGBEMI

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