14D2285341 CLIA NUMBER - BRIGHTSIDE - ROSELLE

Laboratory Demographics

  • CLIA Code: 14D2285341
  • Facility Name: BRIGHTSIDE - ROSELLE
  • Facility Address: 400 LAKE ST - STE 302A
    ROSELLE, IL
    ZIP 60172
  • Facility Phone: 602 248-8886
  • Facility Type: Other - OUTPATIENT TREATMENT PROG
  • Facility Type: Waiver
  • Lab Director: JUSTIN M. ABEYTA
  • NPI Number: 1760020663
  • Taxonomy: 261QM0801X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2285341
LAB Type Other - OUTPATIENT TREATMENT PROG
Facility Name BRIGHTSIDE - ROSELLE
Street 400 LAKE ST - STE 302A
City ROSELLE
State IL
ZIP 60172
Phone 602 248-8886
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/11/2025
Certificate Expiration Date 7/10/2027
Facility Type Other - OUTPATIENT TREATMENT PROG
Lab Director JUSTIN M. ABEYTA

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