14D2262911 CLIA NUMBER - DERICK DERMATOLOGY, LLC

Laboratory Demographics

  • CLIA Code: 14D2262911
  • Facility Name: DERICK DERMATOLOGY, LLC
  • Facility Address: 12736 STATE ROUTE 59 - UNIT 102
    PLAINFIELD, IL
    ZIP 60585
  • Facility Phone: 847 381-8899
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AMY DERICK
  • NPI Number: 1225526627
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 14D2262911
LAB Type Physician Office
Facility Name DERICK DERMATOLOGY, LLC
Street 12736 STATE ROUTE 59 - UNIT 102
City PLAINFIELD
State IL
ZIP 60585
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 6/21/2024
Certificate Expiration Date 6/20/2026
Facility Type Physician Office
Lab Director AMY DERICK

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