14D2201115 CLIA NUMBER - LAKE ZURICH CUSD 95

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Laboratory Demographics

CLIA Number: 14D2201115

Facility Name: LAKE ZURICH CUSD 95

Facility Address:
832 S RAND ROAD
LAKE ZURICH, IL
ZIP 60047
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Facility Phone Number: 847 540-4973

Facility Type: School/Student Health Service

Certificate Type: Waiver

NPI Number: 1376616789

Taxonomy: 111N00000X - Chiropractor
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

CLIA Record

Field Name	Field Value
CLIA Number	14D2201115
LAB Type	School/Student Health Service
Facility Name	LAKE ZURICH CUSD 95
Street	832 S RAND ROAD
City	LAKE ZURICH
State	IL
ZIP	60047
Phone	847 540-4973
CertificateType	4
CertificateEffectiveDate	11/18/2022
CertificateExpirationDate	11/17/2024
FacilityType	Waiver

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