Healthcare Provider Details

I. General information

NPI: 1386548493
Provider Name (Legal Business Name): NIDA LAB CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 TRANSAM PLAZA DR STE 16
OAKBROOK TERRACE IL
60181-4364
US

IV. Provider business mailing address

1 TRANSAM PLAZA DR STE 16
OAKBROOK TERRACE IL
60181-4364
US

V. Phone/Fax

Practice location:
  • Phone: 630-440-7786
  • Fax: 312-807-3550
Mailing address:
  • Phone: 630-440-7786
  • Fax: 312-807-3550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZC0006X
TaxonomyClinical Pathology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MOQUEET A SYED
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 630-440-7786