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General NPI Number Information
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NPI Number | 1952599532
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Entity Type | Organization
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Legal Business Name | BIORAD MEDICAL LABORATORY,INC.
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 10/20/2009
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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 | 708-692-5499
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Fax |
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Provider Business Mailing 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 | 708-692-5499
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. ONESIMO FLORES SR.
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Credential |
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Telephone | 708-692-5499
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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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