14D2242192 CLIA NUMBER - WINCHESTER AMBULATORY SURGERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 14D2242192
  • Facility Name: WINCHESTER AMBULATORY SURGERY CENTER LLC
  • Facility Address: 1870 W WINCHESTER RD - STE 146
    LIBERTYVILLE, IL
    ZIP 60048
  • Facility Phone: 847 533-3077
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: SEAN LEE
  • NPI Number: 1336287168
  • Taxonomy: 207RG0100X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2242192
LAB Type Ambulatory Surgery Center
Facility Name WINCHESTER AMBULATORY SURGERY CENTER LLC
Street 1870 W WINCHESTER RD - STE 146
City LIBERTYVILLE
State IL
ZIP 60048
Phone 847 533-3077
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/5/2023
Certificate Expiration Date 11/4/2025
Facility Type Ambulatory Surgery Center
Lab Director SEAN LEE

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