14D2064591 CLIA NUMBER - PARK RIDGE LAB

Laboratory Demographics

  • CLIA Code: 14D2064591
  • Facility Name: PARK RIDGE LAB
  • Facility Address: 7157 W HOWARD ST
    NILES, IL
    ZIP 60714
  • Facility Phone: 847 696-9900
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: SAM SPERON M D
  • NPI Number: 1043427826
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2064591
LAB Type Physician Office
Facility Name PARK RIDGE LAB
Street 7157 W HOWARD ST
City NILES
State IL
ZIP 60714
Phone 847 696-9900
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/22/2025
Certificate Expiration Date 8/21/2027
Facility Type Physician Office
Lab Director SAM SPERON M D

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