14D2040744 CLIA NUMBER - ELMWOOD PARK SAME DAY SURGERY CENTER

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Laboratory Demographics

CLIA Number: 14D2040744

Facility Name: ELMWOOD PARK SAME DAY SURGERY CENTER

Facility Address:
1614 N HARLEM AVE, 2ND FL
ELMWOOD PARK, IL
ZIP 60707
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Facility Phone Number: 847 869-9700

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1194159467

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D2040744
LAB Type	Ambulatory Surgery Center
Facility Name	ELMWOOD PARK SAME DAY SURGERY CENTER
Street	1614 N HARLEM AVE, 2ND FL
City	ELMWOOD PARK
State	IL
ZIP	60707
Phone	847 869-9700
CertificateType	4
CertificateEffectiveDate	5/9/2024
CertificateExpirationDate	5/8/2026
FacilityType	Waiver

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