14D0706197 CLIA NUMBER - CENTER STREET MEDICAL S C

Laboratory Demographics

  • CLIA Code: 14D0706197
  • Facility Name: CENTER STREET MEDICAL S C
  • Facility Address: 103 HAVEN RD, STE 2
    ELMHURST, IL
    ZIP 60126
  • Facility Phone: 630 595-9988
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PAUL M. BAUBLY MD
  • NPI Number: 1114119245
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D0706197
LAB Type Physician Office
Facility Name CENTER STREET MEDICAL S C
Street 103 HAVEN RD, STE 2
City ELMHURST
State IL
ZIP 60126
Phone 630 595-9988
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director PAUL M. BAUBLY MD

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