14D2089142 CLIA NUMBER - PREFERRED SURGICENTER LLC

Laboratory Demographics

  • CLIA Code: 14D2089142
  • Facility Name: PREFERRED SURGICENTER LLC
  • Facility Address: 10 ORLAND SQUARE DR
    ORLAND PARK, IL
    ZIP 60462
  • Facility Phone: 000 773-2370
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: NASER RUSTOM
  • NPI Number: 1942735253
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 14D2089142
LAB Type Ambulatory Surgery Center
Facility Name PREFERRED SURGICENTER LLC
Street 10 ORLAND SQUARE DR
City ORLAND PARK
State IL
ZIP 60462
Phone 000 773-2370
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/19/2024
Certificate Expiration Date 12/18/2026
Facility Type Ambulatory Surgery Center
Lab Director NASER RUSTOM

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