14D2036450 CLIA NUMBER - NORTH SHORE AMBULATORY CARE

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Laboratory Demographics

CLIA Number: 14D2036450

Facility Name: NORTH SHORE AMBULATORY CARE

Facility Address:
9843 GROSS POINT RD
SKOKIE, IL
ZIP 60076
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Facility Phone Number: 847 674-4646

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1174535215

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D2036450
LAB Type	Physician Office
Facility Name	NORTH SHORE AMBULATORY CARE
Street	9843 GROSS POINT RD
City	SKOKIE
State	IL
ZIP	60076
Phone	847 674-4646
CertificateType	4
CertificateEffectiveDate	2/8/2024
CertificateExpirationDate	2/7/2026
FacilityType	Waiver

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