14D2023643 CLIA NUMBER - ELGIN SURGICARE LLC

Laboratory Demographics

  • CLIA Code: 14D2023643
  • Facility Name: ELGIN SURGICARE LLC
  • Facility Address: 1554 TODD FARM RD
    ELGIN, IL
    ZIP 60123
  • Facility Phone: 773 237-0755
  • Facility Type: Other - AMBULATORY SURGERY SUITE
  • Facility Type: Waiver
  • Lab Director: NASER RUSTOM
  • NPI Number: 1760772750
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2023643
LAB Type Other - AMBULATORY SURGERY SUITE
Facility Name ELGIN SURGICARE LLC
Street 1554 TODD FARM RD
City ELGIN
State IL
ZIP 60123
Phone 773 237-0755
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/28/2025
Certificate Expiration Date 4/27/2027
Facility Type Other - AMBULATORY SURGERY SUITE
Lab Director NASER RUSTOM

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