14D2115509 CLIA NUMBER - DERICK DERMATOLOGY LLC

Laboratory Demographics

  • CLIA Code: 14D2115509
  • Facility Name: DERICK DERMATOLOGY LLC
  • Facility Address: 525 E CONGRESS PKWY, STE 200
    CRYSTAL LAKE, IL
    ZIP 60014
  • Facility Phone: 847 381-8899
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AMY J. DERICK MD
  • NPI Number: 1134664402
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 14D2115509
LAB Type Physician Office
Facility Name DERICK DERMATOLOGY LLC
Street 525 E CONGRESS PKWY, STE 200
City CRYSTAL LAKE
State IL
ZIP 60014
Phone 847 381-8899
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/2/2024
Certificate Expiration Date 8/1/2026
Facility Type Physician Office
Lab Director AMY J. DERICK MD

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