14D1063568 CLIA NUMBER - AESTHETIC SURGERY ASSOCIATES

Laboratory Demographics

CLIA Number: 14D1063568

Facility Name: AESTHETIC SURGERY ASSOCIATES

Facility Address:
1331 W 75TH ST #306
NAPERVILLE, IL
ZIP 60540
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Facility Phone Number: 630 851-3223

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1982726121

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D1063568
LAB Type	Other
Facility Name	AESTHETIC SURGERY ASSOCIATES
Street	1331 W 75TH ST #306
City	NAPERVILLE
State	IL
ZIP	60540
Phone	630 851-3223
CertificateType	4
CertificateEffectiveDate	1/17/2023
CertificateExpirationDate	1/16/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024