14D2130419 CLIA NUMBER - ILLINOIS BACK AND NECK INSTITUTE LLC

Laboratory Demographics

  • CLIA Code: 14D2130419
  • Facility Name: ILLINOIS BACK AND NECK INSTITUTE LLC
  • Facility Address: 360 W BUTTERFIELD RD, STE 100
    ELMHURST, IL
    ZIP 60126
  • Facility Phone: 630 947-8286
  • Facility Type: Other - OFFICE BASED SURGERY
  • Facility Type: Waiver
  • Lab Director: NEEMA BAYRAN
  • NPI Number: 1144834680
  • Taxonomy: 207X00000X - Orthopaedic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 14D2130419
LAB Type Other - OFFICE BASED SURGERY
Facility Name ILLINOIS BACK AND NECK INSTITUTE LLC
Street 360 W BUTTERFIELD RD, STE 100
City ELMHURST
State IL
ZIP 60126
Phone 630 947-8286
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/8/2025
Certificate Expiration Date 5/7/2027
Facility Type Other - OFFICE BASED SURGERY
Lab Director NEEMA BAYRAN

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