14D2175670 CLIA NUMBER - ADVOCATE MEDICAL GROUP WILMETTE

Laboratory Demographics

CLIA Number: 14D2175670

Facility Name: ADVOCATE MEDICAL GROUP WILMETTE

Facility Address:
3232 LAKE AVE
WILMETTE, IL
ZIP 60091
Get Directions

Facility Phone Number: 773 295-3101

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1730262312

Taxonomy: 261QR0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D2175670
LAB Type	Physician Office
Facility Name	ADVOCATE MEDICAL GROUP WILMETTE
Street	3232 LAKE AVE
City	WILMETTE
State	IL
ZIP	60091
Phone	773 295-3101
CertificateType	4
CertificateEffectiveDate	11/26/2023
CertificateExpirationDate	11/25/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

This page was last updated on: 4/23/2024