14D0914685 CLIA NUMBER - GLENBROOK MEDICAL ASSOCIATES EAST

Laboratory Demographics

  • CLIA Code: 14D0914685
  • Facility Name: GLENBROOK MEDICAL ASSOCIATES EAST
  • Facility Address: 1007 CHURCH STREET-SUITE 100
    EVANSTON, IL
    ZIP 60201
  • Facility Phone: 847 475-4555
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EMILY ANDREW
  • NPI Number: 1619143997
  • Taxonomy: 282N00000X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 14D0914685
LAB Type Physician Office
Facility Name GLENBROOK MEDICAL ASSOCIATES EAST
Street 1007 CHURCH STREET-SUITE 100
City EVANSTON
State IL
ZIP 60201
Phone 847 475-4555
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/3/2024
Certificate Expiration Date 3/2/2026
Facility Type Physician Office
Lab Director EMILY ANDREW

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