14D2134494 CLIA NUMBER - CGH DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 14D2134494
  • Facility Name: CGH DERMATOLOGY
  • Facility Address: 101 E MILLER RD
    STERLING, IL
    ZIP 61081
  • Facility Phone: 815 625-0400
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MARK MORAN
  • NPI Number: 1548540636
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2134494
LAB Type Physician Office
Facility Name CGH DERMATOLOGY
Street 101 E MILLER RD
City STERLING
State IL
ZIP 61081
Phone 815 625-0400
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 2/16/2025
Certificate Expiration Date 2/15/2027
Facility Type Physician Office
Lab Director MARK MORAN

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