14D0690725 CLIA NUMBER - CENTER FOR FACIAL PLASTIC SURGERY

Laboratory Demographics

CLIA Number: 14D0690725

Facility Name: CENTER FOR FACIAL PLASTIC SURGERY

Facility Address:
515 OLD NORTHWEST HWY
BARRINGTON, IL
ZIP 60010
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Facility Phone Number: 847 304-1000

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1134343866

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D0690725
LAB Type	Ambulatory Surgery Center
Facility Name	CENTER FOR FACIAL PLASTIC SURGERY
Street	515 OLD NORTHWEST HWY
City	BARRINGTON
State	IL
ZIP	60010
Phone	847 304-1000
CertificateType	4
CertificateEffectiveDate	11/26/2023
CertificateExpirationDate	11/25/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024