14D0414842 CLIA NUMBER - ENDEAVOR HEALTH - HIGHLAND PARK HOSP (UROLOGY)

Laboratory Demographics

  • CLIA Code: 14D0414842
  • Facility Name: ENDEAVOR HEALTH - HIGHLAND PARK HOSP (UROLOGY)
  • Facility Address: 767 PARK AVE WEST, STE B100
    HIGHLAND PARK, IL
    ZIP 60035
  • Facility Phone: 847 503-3000
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: BRIAN V. LE
  • NPI Number: 1386012409
  • Taxonomy: 1041C0700X - Social Worker

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CLIA Record

Field Name Field Value
CLIA Number 14D0414842
LAB Type Physician Office
Facility Name ENDEAVOR HEALTH - HIGHLAND PARK HOSP (UROLOGY)
Street 767 PARK AVE WEST, STE B100
City HIGHLAND PARK
State IL
ZIP 60035
Phone 847 503-3000
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director BRIAN V. LE

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