14D2142112 CLIA NUMBER - CENTEGRA MCHENRY HOSPITAL - WEIGHT LOSS SURGERY

Laboratory Demographics

  • CLIA Code: 14D2142112
  • Facility Name: CENTEGRA MCHENRY HOSPITAL - WEIGHT LOSS SURGERY
  • Facility Address: 10350 HALIGUS ROAD MOB 1 SUITE 220
    HUNTLEY, IL
    ZIP 60142
  • Facility Phone: 847 802-7241
  • Facility Type: Hospital
  • Facility Type: Waiver
  • Lab Director: AMIR HEYDARI MD
  • NPI Number: 1568904597
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2142112
LAB Type Hospital
Facility Name CENTEGRA MCHENRY HOSPITAL - WEIGHT LOSS SURGERY
Street 10350 HALIGUS ROAD MOB 1 SUITE 220
City HUNTLEY
State IL
ZIP 60142
Phone 847 802-7241
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/3/2024
Certificate Expiration Date 1/2/2026
Facility Type Hospital
Lab Director AMIR HEYDARI MD

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