14D2030411 CLIA NUMBER - METRO CHICAGO SURGICAL ONCOLOGY

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Laboratory Demographics

CLIA Number: 14D2030411

Facility Name: METRO CHICAGO SURGICAL ONCOLOGY

Facility Address:
3201 OLD GLENVIEW RD STE 205
WILMETTE, IL
ZIP 60091
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Facility Phone Number: 847 251-1205

Facility Type: Other - PHYSICIAN OWNED LAB

Certificate Type: Accreditation

NPI Number: 1043501448

Taxonomy: 208800000X - Urology
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

CLIA Record

Field Name	Field Value
CLIA Number	14D2030411
LAB Type	Other - PHYSICIAN OWNED LAB
Facility Name	METRO CHICAGO SURGICAL ONCOLOGY
Street	3201 OLD GLENVIEW RD STE 205
City	WILMETTE
State	IL
ZIP	60091
Phone	847 251-1205
CertificateType	1
CertificateEffectiveDate	11/19/2022
CertificateExpirationDate	11/18/2024
FacilityType	Accreditation

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