14D2176706 CLIA NUMBER - FAVIA PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 14D2176706
  • Facility Name: FAVIA PRIMARY CARE
  • Facility Address: 241 E COMMERCE DR - STE 102
    CRYSTAL LAKE, IL
    ZIP 60014
  • Facility Phone: 815 276-0150
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PHILIP FAVIA M D
  • NPI Number: 1669964300
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D2176706
LAB Type Physician Office
Facility Name FAVIA PRIMARY CARE
Street 241 E COMMERCE DR - STE 102
City CRYSTAL LAKE
State IL
ZIP 60014
Phone 815 276-0150
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/20/2023
Certificate Expiration Date 12/19/2025
Facility Type Physician Office
Lab Director PHILIP FAVIA M D

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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