14D2163587 CLIA NUMBER - PREMIER CARDIAC SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 14D2163587
  • Facility Name: PREMIER CARDIAC SURGERY CENTER
  • Facility Address: 11560 S KEDZIE AVE - STE 102
    MERRIONETTE PARK, IL
    ZIP 60803
  • Facility Phone: 708 972-7520
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: RONALD E. STELLA M D
  • NPI Number: 1922664622
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2163587
LAB Type Ambulatory Surgery Center
Facility Name PREMIER CARDIAC SURGERY CENTER
Street 11560 S KEDZIE AVE - STE 102
City MERRIONETTE PARK
State IL
ZIP 60803
Phone 708 972-7520
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/18/2025
Certificate Expiration Date 3/17/2027
Facility Type Ambulatory Surgery Center
Lab Director RONALD E. STELLA M D

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