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General NPI Number Information
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NPI Number | 1366166290
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Entity Type | Organization
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Legal Business Name | TAAG GENETICS CORP.
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Dates
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Enumeration Date | 10/04/2022
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Last Update Date | 10/04/2022
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Provider Practice Location Address
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Address Line | 200 W NORTH AVE STE 700
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City | WEST CHICAGO
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State | IL
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Zip | 60185-6242
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Country | US
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Telephone | 630-912-5988
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Fax | 630-946-5555
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Provider Business Mailing Address
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Address Line | 200 W NORTH AVE STE 700
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City | WEST CHICAGO
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State | IL
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Zip | 60185-6242
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Country | US
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Telephone | 630-912-5988
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Fax | 630-946-5555
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Authorized Official
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Title or Position | LAB DIRECTOR
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Name | ROBERT LEE
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Credential |
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Telephone | 630-394-3588
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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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