14D2117799 CLIA NUMBER - ILLINOIS UROLOGIC HEALTH SURGEONS

Laboratory Demographics

  • CLIA Code: 14D2117799
  • Facility Name: ILLINOIS UROLOGIC HEALTH SURGEONS
  • Facility Address: 215 E FIRST ST
    DIXON, IL
    ZIP 61021
  • Facility Phone: 815 664-2617
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: STEVE CHUNG MD
  • NPI Number: 1780809285
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 14D2117799
LAB Type Physician Office
Facility Name ILLINOIS UROLOGIC HEALTH SURGEONS
Street 215 E FIRST ST
City DIXON
State IL
ZIP 61021
Phone 815 664-2617
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 8/23/2024
Certificate Expiration Date 8/22/2026
Facility Type Physician Office
Lab Director STEVE CHUNG MD

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This page was last updated on: 3/20/2025