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General NPI Number Information
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NPI Number | 1720229305
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Entity Type | Organization
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Legal Business Name | BIO-RAD MEDICAL LABORATORY,INC.
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Dates
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Enumeration Date | 03/11/2009
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Last Update Date | 03/11/2009
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Provider Practice Location Address
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Address Line | 5817 W ROOSEVELT RD
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City | CICERO
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State | IL
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Zip | 60804-1136
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Country | US
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Telephone | 708-477-6617
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Fax | 708-477-6617
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Provider Business Mailing Address
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Address Line | 6116 ROOSEVELT RD
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City | OAK PARK
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State | IL
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Zip | 60304-2301
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Country | US
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Telephone | 708-477-6617
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Fax | 708-477-6617
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ONESIMO FLORES SR.
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Credential |
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Telephone | 708-652-5499
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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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