14D2233706 CLIA NUMBER - BROOKFIELD SD 95

Laboratory Demographics

  • CLIA Code: 14D2233706
  • Facility Name: BROOKFIELD SD 95
  • Facility Address: 1214 RAYMOND AVE
    LA GRANGE PARK, IL
    ZIP 60526
  • Facility Phone: 708 588-8706
  • Facility Type: School/Student Health Service
  • Facility Type: Waiver
  • Lab Director: MARK L. KUZNIEWSKI
  • NPI Number: 1225612534
  • Taxonomy: 1223S0112X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 14D2233706
LAB Type School/Student Health Service
Facility Name BROOKFIELD SD 95
Street 1214 RAYMOND AVE
City LA GRANGE PARK
State IL
ZIP 60526
Phone 708 588-8706
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/25/2025
Certificate Expiration Date 8/24/2027
Facility Type School/Student Health Service
Lab Director MARK L. KUZNIEWSKI

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