15D2298390 CLIA NUMBER - PLUM CREEK SURGERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 15D2298390
  • Facility Name: PLUM CREEK SURGERY CENTER LLC
  • Facility Address: 9200 CALUMET AVE N-300
    MUNSTER, IN
    ZIP 46321
  • Facility Phone: 708 334-1241
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. RICHARD LIM
  • NPI Number: 1043080674
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2298390
LAB Type Ambulatory Surgery Center
Facility Name PLUM CREEK SURGERY CENTER LLC
Street 9200 CALUMET AVE N-300
City MUNSTER
State IN
ZIP 46321
Phone 708 334-1241
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/1/2024
Certificate Expiration Date 1/31/2026
Facility Type Ambulatory Surgery Center
Lab Director DR. RICHARD LIM

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