14D1078373 CLIA NUMBER - MIDWEST CENTER FOR ADVANCED IMAGING

Laboratory Demographics

CLIA Number: 14D1078373

Facility Name: MIDWEST CENTER FOR ADVANCED IMAGING

Facility Address:
4355 MONTGOMERY ROAD
NAPERVILLE, IL
ZIP 60564
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Facility Phone Number: 630 236-8300

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1912220468

Taxonomy: 261QR0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D1078373
LAB Type	Other
Facility Name	MIDWEST CENTER FOR ADVANCED IMAGING
Street	4355 MONTGOMERY ROAD
City	NAPERVILLE
State	IL
ZIP	60564
Phone	630 236-8300
CertificateType	4
CertificateEffectiveDate	1/8/2024
CertificateExpirationDate	1/7/2026
FacilityType	Waiver

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