14D2229750 CLIA NUMBER - OAK ASC, LLC

Laboratory Demographics

  • CLIA Code: 14D2229750
  • Facility Name: OAK ASC, LLC
  • Facility Address: 6712 N CONVENT ST - STE 200
    BOURBONNAIS, IL
    ZIP 60914
  • Facility Phone: 815 348-9500
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: TOMASZ T. ANTKOWIAK
  • NPI Number: 1962070896
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2229750
LAB Type Ambulatory Surgery Center
Facility Name OAK ASC, LLC
Street 6712 N CONVENT ST - STE 200
City BOURBONNAIS
State IL
ZIP 60914
Phone 815 348-9500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/15/2025
Certificate Expiration Date 7/14/2027
Facility Type Ambulatory Surgery Center
Lab Director TOMASZ T. ANTKOWIAK

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