14D1041895 CLIA NUMBER - RIVERSIDE AMBULATORY SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 14D1041895
  • Facility Name: RIVERSIDE AMBULATORY SURGERY CENTER
  • Facility Address: 300 RIVERSIDE DR - SUITE 1100
    BOURBONNAIS, IL
    ZIP 60914
  • Facility Phone: 815 802-3170
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: STEVEN WILLIAMS
  • NPI Number: 1851407373
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D1041895
LAB Type Ambulatory Surgery Center
Facility Name RIVERSIDE AMBULATORY SURGERY CENTER
Street 300 RIVERSIDE DR - SUITE 1100
City BOURBONNAIS
State IL
ZIP 60914
Phone 815 802-3170
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/15/2025
Certificate Expiration Date 6/14/2027
Facility Type Ambulatory Surgery Center
Lab Director STEVEN WILLIAMS

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