14D2095792 CLIA NUMBER - HYDE PARK SURGICAL CENTER

Laboratory Demographics

  • CLIA Code: 14D2095792
  • Facility Name: HYDE PARK SURGICAL CENTER
  • Facility Address: 1644 EAST 53RD ST
    CHICAGO, IL
    ZIP 60615
  • Facility Phone: 773 752-6340
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DARREL SALDANHA
  • NPI Number: 1205214103
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2095792
LAB Type Ambulatory Surgery Center
Facility Name HYDE PARK SURGICAL CENTER
Street 1644 EAST 53RD ST
City CHICAGO
State IL
ZIP 60615
Phone 773 752-6340
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/12/2025
Certificate Expiration Date 5/11/2027
Facility Type Ambulatory Surgery Center
Lab Director DARREL SALDANHA

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