14D1039461 CLIA NUMBER - LAKESHORE SURGERY CENTER LLC

Laboratory Demographics

CLIA Number: 14D1039461

Facility Name: LAKESHORE SURGERY CENTER LLC

Facility Address:
7200 NORTH WESTERN AVENUE
CHICAGO, IL
ZIP 60645
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Facility Phone Number: (773) 761-6900

Facility Type: AMBULATORY SURGERY CENTER

Certificate Type: Waiver

NPI Number: 1881863637

Taxonomy: 261QA1903X - Clinic/Center

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

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This page was last updated on: 5/11/2023