14D2077929 CLIA NUMBER - ACTIVE CARE CENTER S C

Laboratory Demographics

  • CLIA Code: 14D2077929
  • Facility Name: ACTIVE CARE CENTER S C
  • Facility Address: 609 NMAIN ST - STE 101
    MOUNT PROSPECT, IL
    ZIP 60056
  • Facility Phone: 847 670-1111
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ALBERT PAWLUSIEWICZ
  • NPI Number: 1669857025
  • Taxonomy: 111NX0800X - Chiropractor

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CLIA Record

Field Name Field Value
CLIA Number 14D2077929
LAB Type Physician Office
Facility Name ACTIVE CARE CENTER S C
Street 609 NMAIN ST - STE 101
City MOUNT PROSPECT
State IL
ZIP 60056
Phone 847 670-1111
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/19/2024
Certificate Expiration Date 5/18/2026
Facility Type Physician Office
Lab Director ALBERT PAWLUSIEWICZ

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