14D2201002 CLIA NUMBER - LASER SPINE CENTER OF CHICAGO

Laboratory Demographics

  • CLIA Code: 14D2201002
  • Facility Name: LASER SPINE CENTER OF CHICAGO
  • Facility Address: 16604 S 107TH ST
    ORLAND PARK, IL
    ZIP 60467
  • Facility Phone: 708 966-8000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: FARIS ABUSHARIF M D
  • NPI Number: 1558920579
  • Taxonomy: 207LP2900X - Anesthesiology

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CLIA Record

Field Name Field Value
CLIA Number 14D2201002
LAB Type Physician Office
Facility Name LASER SPINE CENTER OF CHICAGO
Street 16604 S 107TH ST
City ORLAND PARK
State IL
ZIP 60467
Phone 708 966-8000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/18/2024
Certificate Expiration Date 11/17/2026
Facility Type Physician Office
Lab Director FARIS ABUSHARIF M D

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