14D1071140 CLIA NUMBER - CHICAGO SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 14D1071140
  • Facility Name: CHICAGO SURGERY CENTER
  • Facility Address: 3536 W FULLERTON
    CHICAGO, IL
    ZIP 60647
  • Facility Phone: 312 761-0100
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ALEKSANDR GOLDVEKHT M D
  • NPI Number: 1861684458
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D1071140
LAB Type Ambulatory Surgery Center
Facility Name CHICAGO SURGERY CENTER
Street 3536 W FULLERTON
City CHICAGO
State IL
ZIP 60647
Phone 312 761-0100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/19/2025
Certificate Expiration Date 7/18/2027
Facility Type Ambulatory Surgery Center
Lab Director ALEKSANDR GOLDVEKHT M D

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