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General NPI Number Information
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NPI Number | 1326972274
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Entity Type | Organization
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Legal Business Name | DE LA LUZ LABORATORY LLC
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Dates
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Enumeration Date | 06/08/2026
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Last Update Date | 06/08/2026
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Provider Practice Location Address
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Address Line | 6027 N CICERO AVE
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City | CHICAGO
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State | IL
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Zip | 60646-4301
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Country | US
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Telephone | 312-415-7097
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Fax |
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Provider Business Mailing Address
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Address Line | 6027 N CICERO AVE
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City | CHICAGO
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State | IL
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Zip | 60646-4301
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LAB OWNER
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Name | MARIA ESMERALDA AMARO HERNANDEZ
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Credential |
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Telephone | 312-415-7097
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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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