14D2113757 CLIA NUMBER - MEDLOGIC LLC

Laboratory Demographics

  • CLIA Code: 14D2113757
  • Facility Name: MEDLOGIC LLC
  • Facility Address: 2101 WAUKEGAN RD, STE 303
    BANNOCKBURN, IL
    ZIP 60015
  • Facility Phone: 847 881-6858
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JILL GREEN MD
  • NPI Number: 1477900785
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2113757
LAB Type Physician Office
Facility Name MEDLOGIC LLC
Street 2101 WAUKEGAN RD, STE 303
City BANNOCKBURN
State IL
ZIP 60015
Phone 847 881-6858
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/31/2024
Certificate Expiration Date 5/30/2026
Facility Type Physician Office
Lab Director JILL GREEN MD

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