14D2327246 CLIA NUMBER - LIGHTHOUSE RECOVER, INC

Laboratory Demographics

  • CLIA Code: 14D2327246
  • Facility Name: LIGHTHOUSE RECOVER, INC
  • Facility Address: 308 WALNUT ST
    ST CHARLES, IL
    ZIP 60174
  • Facility Phone: 630 940-2468
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: NATHAN P. LANTHRUM
  • NPI Number: 1700246139
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2327246
LAB Type Practitioner Other
Facility Name LIGHTHOUSE RECOVER, INC
Street 308 WALNUT ST
City ST CHARLES
State IL
ZIP 60174
Phone 630 940-2468
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/18/2025
Certificate Expiration Date 7/17/2027
Facility Type Practitioner Other
Lab Director NATHAN P. LANTHRUM

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