14D2244483 CLIA NUMBER - THRIVE INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 14D2244483
  • Facility Name: THRIVE INTERNAL MEDICINE
  • Facility Address: 400 SKOKIE BLVD - STE 405
    NORTHBROOK, IL
    ZIP 60062
  • Facility Phone: 224 215-8585
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KATHRYN PETRUNGARO
  • NPI Number: 1952069163
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2244483
LAB Type Physician Office
Facility Name THRIVE INTERNAL MEDICINE
Street 400 SKOKIE BLVD - STE 405
City NORTHBROOK
State IL
ZIP 60062
Phone 224 215-8585
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/2/2023
Certificate Expiration Date 12/1/2025
Facility Type Physician Office
Lab Director KATHRYN PETRUNGARO

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