14D2194946 CLIA NUMBER - DU PAGE MEDICAL GROUP - LISLE RADIOLOGY

Laboratory Demographics

  • CLIA Code: 14D2194946
  • Facility Name: DU PAGE MEDICAL GROUP - LISLE RADIOLOGY
  • Facility Address: 430 WARRENVILLE RD - STE 110
    LISLE, IL
    ZIP 60532
  • Facility Phone: 630 545-7880
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAJIT SHETTY M D
  • NPI Number: 1528309291
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 14D2194946
LAB Type Physician Office
Facility Name DU PAGE MEDICAL GROUP - LISLE RADIOLOGY
Street 430 WARRENVILLE RD - STE 110
City LISLE
State IL
ZIP 60532
Phone 630 545-7880
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/5/2024
Certificate Expiration Date 10/4/2026
Facility Type Physician Office
Lab Director RAJIT SHETTY M D

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