14D2127679 CLIA NUMBER - PROCARE MEDICAL GROUP LLC

Laboratory Demographics

CLIA Number: 14D2127679

Facility Name: PROCARE MEDICAL GROUP LLC

Facility Address:
3000 DUNDEE ROAD, SUITE 313
NORTHBROOK, IL
ZIP 60062
Get Directions

Facility Phone Number: 847 383-6224

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1407308752

Taxonomy: 208D00000X - General Practice
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	14D2127679
LAB Type	Physician Office
Facility Name	PROCARE MEDICAL GROUP LLC
Street	3000 DUNDEE ROAD, SUITE 313
City	NORTHBROOK
State	IL
ZIP	60062
Phone	847 383-6224
CertificateType	4
CertificateEffectiveDate	3/16/2023
CertificateExpirationDate	3/15/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

This page was last updated on: 4/23/2024