14D2238735 CLIA NUMBER - AMOUR-PROPRE ESTHETE COLLECTIVE

Laboratory Demographics

  • CLIA Code: 14D2238735
  • Facility Name: AMOUR-PROPRE ESTHETE COLLECTIVE
  • Facility Address: 312 W 52ND PLACE
    CHICAGO, IL
    ZIP 60609
  • Facility Phone: 708 506-1536
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: SHAUNTELLE S. HENDERSON
  • NPI Number: 1215698527
  • Taxonomy: 305S00000X - Point of Service

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CLIA Record

Field Name Field Value
CLIA Number 14D2238735
LAB Type Mobile Laboratory
Facility Name AMOUR-PROPRE ESTHETE COLLECTIVE
Street 312 W 52ND PLACE
City CHICAGO
State IL
ZIP 60609
Phone 708 506-1536
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/6/2023
Certificate Expiration Date 10/5/2025
Facility Type Mobile Laboratory
Lab Director SHAUNTELLE S. HENDERSON

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