Healthcare Provider Details

I. General information

NPI: 1982365227
Provider Name (Legal Business Name): ONSITE TESTING INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2022
Last Update Date: 02/01/2022
Certification Date: 02/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2316 W ROSEMONT AVE
CHICAGO IL
60659-3348
US

IV. Provider business mailing address

2316 W ROSEMONT AVE APT 2
CHICAGO IL
60659-3348
US

V. Phone/Fax

Practice location:
  • Phone: 872-310-8370
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code246RM2200X
TaxonomyMedical Laboratory Technician
License Number
License Number State

VIII. Authorized Official

Name: SALMAN MOHAMMED
Title or Position: PRESIDENT
Credential:
Phone: 872-310-8370