| NPI | 1013530682 |
|---|---|
| Former Legal Business Name | NA |
| Entity Type | Organization |
| Authorized Contact | MOHAMMED ELSHAREIF Owner 708-238-9913 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2020-05-18 |
| Last Update Date | 2022-03-17 |