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General NPI Number Information
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NPI Number | 1154515377
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Entity Type | Organization
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Legal Business Name | MEDLAB INC
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Dates
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Enumeration Date | 08/30/2007
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Last Update Date | 08/16/2023
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Provider Practice Location Address
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Address Line | 35 GAYLORD ST
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City | ELK GROVE VILLAGE
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State | IL
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Zip | 60007-1104
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Country | US
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Telephone | 847-979-8184
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Fax | 847-979-8284
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Provider Business Mailing Address
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Address Line | 35 GAYLORD ST
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City | ELK GROVE VILLAGE
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State | IL
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Zip | 60007-1104
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Country | US
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Telephone | 847-979-8184
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Fax | 847-979-8284
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ARSHADULLAH SYED
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Credential |
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Telephone | 630-677-5272
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 14D1071933
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License Number State | IL
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