14D1053938 CLIA NUMBER - RAVINE WAY SURGERY CENTER L L C

Laboratory Demographics

  • CLIA Code: 14D1053938
  • Facility Name: RAVINE WAY SURGERY CENTER L L C
  • Facility Address: 2350 RAVINE WAY, SUITE 500
    GLENVIEW, IL
    ZIP 60025
  • Facility Phone: 847 832-1555
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MELODY WINTER-JABECK
  • NPI Number: 1457385668
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D1053938
LAB Type Ambulatory Surgery Center
Facility Name RAVINE WAY SURGERY CENTER L L C
Street 2350 RAVINE WAY, SUITE 500
City GLENVIEW
State IL
ZIP 60025
Phone 847 832-1555
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/8/2024
Certificate Expiration Date 5/7/2026
Facility Type Ambulatory Surgery Center
Lab Director MELODY WINTER-JABECK

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