14D2241387 CLIA NUMBER - MYMENOPAUSERX GYNECOLOGY GROUP

Laboratory Demographics

  • CLIA Code: 14D2241387
  • Facility Name: MYMENOPAUSERX GYNECOLOGY GROUP
  • Facility Address: 1604 N MAIN ST
    WHEATON, IL
    ZIP 60187
  • Facility Phone: 815 451-6647
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BARBRA S. HANNA
  • NPI Number: 1396311288
  • Taxonomy: 207VG0400X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 14D2241387
LAB Type Physician Office
Facility Name MYMENOPAUSERX GYNECOLOGY GROUP
Street 1604 N MAIN ST
City WHEATON
State IL
ZIP 60187
Phone 815 451-6647
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/27/2023
Certificate Expiration Date 10/26/2025
Facility Type Physician Office
Lab Director BARBRA S. HANNA

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