14D0710077 CLIA NUMBER - RIVER NORTH SAME DAY SURGERY

Laboratory Demographics

CLIA Number: 14D0710077

Facility Name: RIVER NORTH SAME DAY SURGERY

Facility Address:
ONE EAST ERIE, STE 300
CHICAGO, IL
ZIP 60611
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Facility Phone Number: 312 649-3939

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1922141647

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D0710077
LAB Type	Ambulatory Surgery Center
Facility Name	RIVER NORTH SAME DAY SURGERY
Street	ONE EAST ERIE, STE 300
City	CHICAGO
State	IL
ZIP	60611
Phone	312 649-3939
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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