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General NPI Number Information
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NPI Number | 1174967228
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Entity Type | Organization
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Legal Business Name | ITXM DIAGNOSTICS INC
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Dates
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Enumeration Date | 04/19/2013
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Last Update Date | 04/19/2013
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Provider Practice Location Address
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Address Line | 5505 PEARL ST
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City | ROSEMONT
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State | IL
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Zip | 60018-5317
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Country | US
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Telephone | 847-260-2400
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Fax |
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Provider Business Mailing Address
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Address Line | 875 GREENTREE RD 5 PARKWAY CENTER
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City | PITTSBURGH
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State | PA
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Zip | 15220-3508
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Country | US
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Telephone | 412-290-7300
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Fax |
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Authorized Official
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Title or Position | SECRETARY TREASURER
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Name | MR. MARK J GIAQUINTO
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Credential |
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Telephone | 412-209-7302
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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 |
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License Number State |
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