14D2150578 CLIA NUMBER - FOX RIDGE MEDICAL ASSOCIATES

Laboratory Demographics

  • CLIA Code: 14D2150578
  • Facility Name: FOX RIDGE MEDICAL ASSOCIATES
  • Facility Address: 3633 MUNICIPAL DR
    MCHENRY, IL
    ZIP 60050
  • Facility Phone: 815 861-5543
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JEFFREY S. TOMLIN M D
  • NPI Number: 1013402825
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2150578
LAB Type Physician Office
Facility Name FOX RIDGE MEDICAL ASSOCIATES
Street 3633 MUNICIPAL DR
City MCHENRY
State IL
ZIP 60050
Phone 815 861-5543
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/27/2024
Certificate Expiration Date 6/26/2026
Facility Type Physician Office
Lab Director JEFFREY S. TOMLIN M D

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This page was last updated on: 3/20/2025