14D2276062 CLIA NUMBER - LEGACY DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 14D2276062
  • Facility Name: LEGACY DERMATOLOGY
  • Facility Address: 2230 N HUNTINGTON DR
    ALGONQUIN, IL
    ZIP 60102
  • Facility Phone: 847 603-4146
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: LAURENCE M. BRADLEY
  • NPI Number: 1053024554
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 14D2276062
LAB Type Physician Office
Facility Name LEGACY DERMATOLOGY
Street 2230 N HUNTINGTON DR
City ALGONQUIN
State IL
ZIP 60102
Phone 847 603-4146
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 1/10/2025
Certificate Expiration Date 1/9/2027
Facility Type Physician Office
Lab Director LAURENCE M. BRADLEY

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