14D2144262 CLIA NUMBER - SYMETRIA - DES PLAINES OTPT REHAB & SUBOXONE CLNC

Laboratory Demographics

CLIA Number: 14D2144262

Facility Name: SYMETRIA - DES PLAINES OTPT REHAB & SUBOXONE CLNC

Facility Address:
1460 MARKET STREET - STE 300
DES PLAINES, IL
ZIP 60016
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Facility Phone Number: 847 813-2558

Facility Type: Other - OPIOD TRTMNT - OUTPATIENT

Certificate Type: Waiver

NPI Number: 1609214089

Taxonomy: 261QM2800X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.

CLIA Record

Field Name	Field Value
CLIA Number	14D2144262
LAB Type	Other - OPIOD TRTMNT - OUTPATIENT
Facility Name	SYMETRIA - DES PLAINES OTPT REHAB & SUBOXONE CLNC
Street	1460 MARKET STREET - STE 300
City	DES PLAINES
State	IL
ZIP	60016
Phone	847 813-2558
CertificateType	4
CertificateEffectiveDate	2/13/2024
CertificateExpirationDate	2/12/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024