14D2092912 CLIA NUMBER - DUPAGE MED GROUP - WARRENVILLE #310

Laboratory Demographics

  • CLIA Code: 14D2092912
  • Facility Name: DUPAGE MED GROUP - WARRENVILLE #310
  • Facility Address: 430 WARRENVILLE RD, STE 310
    LISLE, IL
    ZIP 60532
  • Facility Phone: 630 789-4910
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SUCHITRA BHAKTA MD
  • NPI Number: 1801963855
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2092912
LAB Type Physician Office
Facility Name DUPAGE MED GROUP - WARRENVILLE #310
Street 430 WARRENVILLE RD, STE 310
City LISLE
State IL
ZIP 60532
Phone 630 789-4910
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/17/2025
Certificate Expiration Date 3/16/2027
Facility Type Physician Office
Lab Director SUCHITRA BHAKTA MD

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