14D1039461 CLIA NUMBER - LAKESHORE SURGERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 14D1039461
  • Facility Name: LAKESHORE SURGERY CENTER LLC
  • Facility Address: 7200 NORTH WESTERN AVENUE
    CHICAGO, IL
    ZIP 60645
  • Facility Phone: 773 761-6900
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ROBERT FINK MD
  • NPI Number: 1881863637
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D1039461
LAB Type Ambulatory Surgery Center
Facility Name LAKESHORE SURGERY CENTER LLC
Street 7200 NORTH WESTERN AVENUE
City CHICAGO
State IL
ZIP 60645
Phone 773 761-6900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/14/2025
Certificate Expiration Date 4/13/2027
Facility Type Ambulatory Surgery Center
Lab Director ROBERT FINK MD

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