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General NPI Number Information
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NPI Number | 1346901303
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Entity Type | Organization
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Legal Business Name | ACE CLINICAL LAB INC
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Dates
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Enumeration Date | 01/03/2022
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Last Update Date | 08/01/2024
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Provider Practice Location Address
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Address Line | 7309 MONTICELLO AVE
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City | SKOKIE
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State | IL
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Zip | 60076-4024
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Country | US
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Telephone | 630-621-0893
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Fax |
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Provider Business Mailing Address
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Address Line | 1959 SENECA DR
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City | HANOVER PARK
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State | IL
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Zip | 60133-6751
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Country | US
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Telephone | 630-621-0893
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHREYAS Y SHAH
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Credential |
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Telephone | 630-621-0893
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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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