| NPI | 1053819722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY M GOLDBERG Chief Executive Officer 708-216-3215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2018-01-29 |
| Last Update Date | 2018-01-29 |