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General NPI Number Information
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NPI Number | 1225749856
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Entity Type | Organization
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Legal Business Name | LUCID LABS HEALTH LLC
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Dates
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Enumeration Date | 12/05/2022
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 2320 W PETERSON AVE STE 200
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City | CHICAGO
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State | IL
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Zip | 60659-5244
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Country | US
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Telephone | 773-531-0206
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Fax |
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Provider Business Mailing Address
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Address Line | 2320 W PETERSON AVE STE 200
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City | CHICAGO
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State | IL
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Zip | 60659-5244
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Country | US
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Telephone | 773-531-0206
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | MR. ABDUL GAFFAR ZAINULABDEEN
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Credential |
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Telephone | 773-531-0206
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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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