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NPI Code Detail

MEDICARE: TAMZON LABS LLC

MEDICARE: TAMZON LABS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1291U00000XClinical Medical Laboratory

General Provider Information

NPI Number : 1417619321
Entity Type Code : Organization
Provider Name (Legal Business Name) : TAMZON LABS LLC
Provider Business Mailing Address
First Line : 1020 CAROLINA DR
Second Line :
City : WEST CHICAGO
State : IL
Zip : 60185-5126
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1020 CAROLINA DR
Second Line :
City : WEST CHICAGO
State : IL
Zip : 60185-5126
Country : US
Telephone Number : 630-876-8504
Fax Number :
Authorized Official
Title or Position : GENERAL MANAGER
Name : MOHAMMED AHMED
Credential :
Telephone Number : 847-561-3626
Provider Enumeration Date : 10/07/2021
Last Update Date : 10/07/2021

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