MEDICARE: ACCURATE MOBILE LAB SERVICES 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
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1932853918
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCURATE MOBILE LAB SERVICES LLC

Provider Business Mailing Address
First Line	:	8723 W 95TH ST
Second Line	:
City	:	HICKORY HILLS
State	:	IL
Zip	:	60457-1732
Country	:	US
Telephone Number	:	708-529-5503
Fax Number	:

Provider Business Practice Location Address
First Line	:	8723 W 95TH ST
Second Line	:
City	:	HICKORY HILLS
State	:	IL
Zip	:	60457-1732
Country	:	US
Telephone Number	:	708-529-5503
Fax Number	:

Authorized Official
Title or Position	:	MEMBER MANAGER
Name	:	MOHAMMED HASSAN ABU REALH
Credential	:	RN
Telephone Number	:	708-529-5503

Provider Enumeration Date	:	02/08/2022
Last Update Date	:	08/17/2023

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