| NPI | 1912909961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FLORA M SAMPANG President 773-283-0944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: IL 14D0997741) |
| Enumeration Date | 2005-06-02 |
| Last Update Date | 2020-08-22 |