14D2156627 CLIA NUMBER - DUPAGE MEDICAL GROUP - WHEATON I M

Laboratory Demographics

  • CLIA Code: 14D2156627
  • Facility Name: DUPAGE MEDICAL GROUP - WHEATON I M
  • Facility Address: 150 E WILLOW AVE - STE 200
    WHEATON, IL
    ZIP 60187
  • Facility Phone: 630 665-6200
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RITA J. HERZING M D
  • NPI Number: 1457596124
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 14D2156627
LAB Type Physician Office
Facility Name DUPAGE MEDICAL GROUP - WHEATON I M
Street 150 E WILLOW AVE - STE 200
City WHEATON
State IL
ZIP 60187
Phone 630 665-6200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/22/2024
Certificate Expiration Date 10/21/2026
Facility Type Physician Office
Lab Director RITA J. HERZING M D

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