MEDICARE: RUSH LAB LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1144173832
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RUSH LAB LLC

Provider Business Mailing Address
First Line	:	3525 W PETERSON AVE STE 113
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-3313
Country	:	US
Telephone Number	:	312-520-4582
Fax Number	:

Provider Business Practice Location Address
First Line	:	3525 W PETERSON AVE STE 113
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-3313
Country	:	US
Telephone Number	:	312-520-4582
Fax Number	:

Authorized Official
Title or Position	:	MANAGING DIRECTOR
Name	:	WAQAS MIRZA
Credential	:
Telephone Number	:	312-520-4582

Provider Enumeration Date	:	02/20/2026
Last Update Date	:	02/20/2026

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Directions to “RUSH LAB LLC ” Practice Location

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