14D1016274 CLIA NUMBER - DEERPATH AMBULATORY SURGICAL CENTER LLC

Laboratory Demographics

  • CLIA Code: 14D1016274
  • Facility Name: DEERPATH AMBULATORY SURGICAL CENTER LLC
  • Facility Address: 1051 W RTE 6 - SUITE 100
    MORRIS, IL
    ZIP 60450
  • Facility Phone: 815 318-5666
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ASHLEY HILLIARD
  • NPI Number: 1215040464
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D1016274
LAB Type Ambulatory Surgery Center
Facility Name DEERPATH AMBULATORY SURGICAL CENTER LLC
Street 1051 W RTE 6 - SUITE 100
City MORRIS
State IL
ZIP 60450
Phone 815 318-5666
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/25/2025
Certificate Expiration Date 8/24/2027
Facility Type Ambulatory Surgery Center
Lab Director ASHLEY HILLIARD

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