14D0924364 CLIA NUMBER - BELMONT/HARLEM SURGERY CENTER L L C

Laboratory Demographics

  • CLIA Code: 14D0924364
  • Facility Name: BELMONT/HARLEM SURGERY CENTER L L C
  • Facility Address: 3101 N HARLEM AVE
    CHICAGO, IL
    ZIP 60634
  • Facility Phone: 773 889-2000
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DAVID M. WOOSENCRAFT
  • NPI Number: 1619210762
  • Taxonomy: 207L00000X - Anesthesiology

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CLIA Record

Field Name Field Value
CLIA Number 14D0924364
LAB Type Ambulatory Surgery Center
Facility Name BELMONT/HARLEM SURGERY CENTER L L C
Street 3101 N HARLEM AVE
City CHICAGO
State IL
ZIP 60634
Phone 773 889-2000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/28/2025
Certificate Expiration Date 1/27/2027
Facility Type Ambulatory Surgery Center
Lab Director DAVID M. WOOSENCRAFT

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