| NPI | 1174405633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AIJAZ AHMED KHAN President 815-908-4738 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 292200000X Dental Laboratory |
| Enumeration Date | 2025-07-24 |
| Last Update Date | 2025-10-06 |