14D0858067 CLIA NUMBER - MIDWEST ENDOSCOPY CENTER

Laboratory Demographics

CLIA Number: 14D0858067

Facility Name: MIDWEST ENDOSCOPY CENTER

Facility Address:
6900 MADISON ST, STE 102
WILLOWBROOK, IL
ZIP 60527
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Facility Phone Number: 630 325-8684

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1801149919

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D0858067
LAB Type	Physician Office
Facility Name	MIDWEST ENDOSCOPY CENTER
Street	6900 MADISON ST, STE 102
City	WILLOWBROOK
State	IL
ZIP	60527
Phone	630 325-8684
CertificateType	4
CertificateEffectiveDate	2/1/2023
CertificateExpirationDate	1/31/2025
FacilityType	Waiver

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