14D0920851 CLIA NUMBER - UNITED SHOCKWAVE SERVICES, LTD

Laboratory Demographics

  • CLIA Code: 14D0920851
  • Facility Name: UNITED SHOCKWAVE SERVICES, LTD
  • Facility Address: 1875 WEST DEMPSTER SUITE G-04
    PARK RIDGE, IL
    ZIP 60068
  • Facility Phone: (847) 823-0340
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: JAMIE EJKA BSN RN
  • NPI Number: 1114312659
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D0920851
LAB Type Other
Facility Name UNITED SHOCKWAVE SERVICES, LTD
Street 1875 WEST DEMPSTER SUITE G-04
City PARK RIDGE
State IL
ZIP 60068
Phone 8478230340
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/10/2024
Certificate Expiration Date 10/9/2026
Facility Type Other
Lab Director JAMIE EJKA BSN RN

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This page was last updated on: 5/18/2026