14D2291844 CLIA NUMBER - ADVANCED GYNECOLOGY PRACTICE LLC

Laboratory Demographics

  • CLIA Code: 14D2291844
  • Facility Name: ADVANCED GYNECOLOGY PRACTICE LLC
  • Facility Address: 3033 OGDEN AVE - STE 300
    LISLE, IL
    ZIP 60532
  • Facility Phone: 331 702-2455
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: FADEL F. AZER
  • NPI Number: 1598462426
  • Taxonomy: 207VG0400X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 14D2291844
LAB Type Physician Office
Facility Name ADVANCED GYNECOLOGY PRACTICE LLC
Street 3033 OGDEN AVE - STE 300
City LISLE
State IL
ZIP 60532
Phone 331 702-2455
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/17/2025
Certificate Expiration Date 10/16/2027
Facility Type Physician Office
Lab Director FADEL F. AZER

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