Healthcare Provider Details

I. General information

NPI: 1568390854
Provider Name (Legal Business Name): R & S LABORATORY AND DIAGNOSTIC TESTING CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 HOLIDAY PLAZA DR STE 182
MATTESON IL
60443-2236
US

IV. Provider business mailing address

600 HOLIDAY PLAZA DR STE 182
MATTESON IL
60443-2236
US

V. Phone/Fax

Practice location:
  • Phone: 708-872-0133
  • Fax:
Mailing address:
  • Phone: 708-872-0133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MS. DAVITA L SAULS
Title or Position: ADMINISTER
Credential:
Phone: 708-872-0133