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General NPI Number Information
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NPI Number | 1972798460
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Entity Type | Organization
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Legal Business Name | B&B MICROBIOLOGY LABORATORY, INC.
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Dates
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Enumeration Date | 09/08/2007
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Last Update Date | 09/08/2007
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Provider Practice Location Address
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Address Line | 1793 BLOOMINGDALE RD SUITE 3
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City | GLENDALE HEIGHTS
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State | IL
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Zip | 60139-3800
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Country | US
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Telephone | 630-933-9213
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Fax |
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Provider Business Mailing Address
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Address Line | 563 GOODWIN DR
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City | BOLINGBROOK
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State | IL
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Zip | 60440-2079
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Country | US
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Telephone | 630-783-8132
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Fax |
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Authorized Official
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Title or Position | LABORATORY DIRECTOR
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Name | DR. SMARANDA M. BADESCU
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Credential | M.D., PH.D.
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Telephone | 630-310-1069
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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 | IL
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