| NPI | 1881351021 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMMED IBRAHIM QUADRI Authorized Official 815-701-1033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2021-11-22 |
| Last Update Date | 2025-09-22 |