14D0420268 CLIA NUMBER - PALOS SURGICENTER LLC

Laboratory Demographics

  • CLIA Code: 14D0420268
  • Facility Name: PALOS SURGICENTER LLC
  • Facility Address: 7340 W COLLEGE DRIVE
    PALOS HEIGHTS, IL
    ZIP 60463
  • Facility Phone: 708 361-3233
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: AMANDA NUNKOVICH
  • NPI Number: 1942335971
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D0420268
LAB Type Ambulatory Surgery Center
Facility Name PALOS SURGICENTER LLC
Street 7340 W COLLEGE DRIVE
City PALOS HEIGHTS
State IL
ZIP 60463
Phone 708 361-3233
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/15/2025
Certificate Expiration Date 6/14/2027
Facility Type Ambulatory Surgery Center
Lab Director AMANDA NUNKOVICH

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