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General NPI Number Information
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NPI Number | 1588280622
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Entity Type | Organization
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Legal Business Name | RADIANCE BIOSCIENCES & CONSULTANCY LLC
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Dates
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Enumeration Date | 06/24/2020
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Last Update Date | 11/23/2022
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Provider Practice Location Address
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Address Line | 1240 IROQUOIS AVE STE 300
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City | NAPERVILLE
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State | IL
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Zip | 60563-8538
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Country | US
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Telephone | 630-995-3722
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Fax | 630-995-3739
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Provider Business Mailing Address
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Address Line | 1240 IROQUOIS AVE STE 300
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City | NAPERVILLE
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State | IL
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Zip | 60563-8538
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Country | US
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Telephone | 630-995-3722
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Fax | 630-995-3739
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Authorized Official
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Title or Position | PRESIDENT/MANAGER
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Name | SIVAKUMAR RAMU
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Credential | PHD
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Telephone | 630-995-3722
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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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