14D2155444 CLIA NUMBER - DERICK DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 14D2155444
  • Facility Name: DERICK DERMATOLOGY
  • Facility Address: 353 BANK DR #400
    MCHENRY, IL
    ZIP 60050
  • Facility Phone: 847 381-8899
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AMY J. DERICK M D
  • NPI Number: 1154998425
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 14D2155444
LAB Type Physician Office
Facility Name DERICK DERMATOLOGY
Street 353 BANK DR #400
City MCHENRY
State IL
ZIP 60050
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 9/28/2024
Certificate Expiration Date 9/27/2026
Facility Type Physician Office
Lab Director AMY J. DERICK M D

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