14D1019155 CLIA NUMBER - BUFFALO GROVE DIALYSIS (D/B/A) ISD BUFFALO GROVE LLC

Laboratory Demographics

  • CLIA Code: 14D1019155
  • Facility Name: BUFFALO GROVE DIALYSIS (D/B/A) ISD BUFFALO GROVE LLC
  • Facility Address: 1291 W DUNDEE RD
    BUFFALO GROVE, IL
    ZIP 60089
  • Facility Phone: 847 253-9400
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: VINCENT A. DISILVESTRO MD
  • NPI Number: 1871519926
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D1019155
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name BUFFALO GROVE DIALYSIS (D/B/A) ISD BUFFALO GROVE LLC
Street 1291 W DUNDEE RD
City BUFFALO GROVE
State IL
ZIP 60089
Phone 847 253-9400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/12/2023
Certificate Expiration Date 11/11/2025
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director VINCENT A. DISILVESTRO MD

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