14D1006058 CLIA NUMBER - GREGORY A WIENER MD SC

Laboratory Demographics

  • CLIA Code: 14D1006058
  • Facility Name: GREGORY A WIENER MD SC
  • Facility Address: 5440 N CUMBERLAND AVE, STE 105
    CHICAGO, IL
    ZIP 60656
  • Facility Phone: 773 763-3990
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GREGORY A. WIENER
  • NPI Number: 1609969765
  • Taxonomy: 208200000X - Plastic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 14D1006058
LAB Type Physician Office
Facility Name GREGORY A WIENER MD SC
Street 5440 N CUMBERLAND AVE, STE 105
City CHICAGO
State IL
ZIP 60656
Phone 773 763-3990
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/12/2025
Certificate Expiration Date 9/11/2027
Facility Type Physician Office
Lab Director GREGORY A. WIENER

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