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General NPI Number Information
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NPI Number | 1639985468
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Entity Type | Organization
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Legal Business Name | PRISM HEALTH LAB USA INC
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Dates
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Enumeration Date | 12/06/2024
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Last Update Date | 12/06/2024
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Provider Practice Location Address
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Address Line | 33 W GRAND AVE STE 500
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City | CHICAGO
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State | IL
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Zip | 60654-6799
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Country | US
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Telephone | 800-325-1812
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Fax |
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Provider Business Mailing Address
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Address Line | 6505 N LONGMEADOW AVE
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City | LINCOLNWOOD
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State | IL
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Zip | 60712-3205
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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 | DIRECTOR/PRESIDENT
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Name | ZUL KAPADIA
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Credential |
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Telephone | 800-325-1812
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number |
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License Number State |
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