14D2166295 CLIA NUMBER - ADVOCATE MED GROUP - MOUNT PROSPECT - OBGYN & FM

Laboratory Demographics

  • CLIA Code: 14D2166295
  • Facility Name: ADVOCATE MED GROUP - MOUNT PROSPECT - OBGYN & FM
  • Facility Address: 1754 GOLF RD
    MOUNT PROSPECT, IL
    ZIP 60056
  • Facility Phone: 847 593-6600
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAL SZCZUPAK
  • NPI Number: 1255451019
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 14D2166295
LAB Type Physician Office
Facility Name ADVOCATE MED GROUP - MOUNT PROSPECT - OBGYN & FM
Street 1754 GOLF RD
City MOUNT PROSPECT
State IL
ZIP 60056
Phone 847 593-6600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/15/2025
Certificate Expiration Date 5/14/2027
Facility Type Physician Office
Lab Director MICHAL SZCZUPAK

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