14D2242893 CLIA NUMBER - DERICK DERMATOLOGY, LLC

Laboratory Demographics

  • CLIA Code: 14D2242893
  • Facility Name: DERICK DERMATOLOGY, LLC
  • Facility Address: 14225 S 95TH AVE - STE 418
    ORLAND PARK, IL
    ZIP 60462
  • Facility Phone: 847 381-8899
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AMY DERICK
  • NPI Number: 1861159675
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 14D2242893
LAB Type Physician Office
Facility Name DERICK DERMATOLOGY, LLC
Street 14225 S 95TH AVE - STE 418
City ORLAND PARK
State IL
ZIP 60462
Phone 847 381-8899
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/15/2023
Certificate Expiration Date 11/14/2025
Facility Type Physician Office
Lab Director AMY DERICK

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