Organization · NPI-2

996

Clinical Medical Laboratory · Chicago, IL

NPI number1891467460
StatusActive
Last updated in NPPESJan 31, 2022

Details

NPI
1891467460
Entity type
Organization (NPI-2)
Legal business name
996
Organization subpart
No
Enumeration date
Oct 1, 2021
Certification date
Jan 31, 2022
Last updated
Jan 31, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
291U00000X Clinical Medical Laboratory––Yes

Other names

  • 996 Labs (Doing Business As)

Practice location

111 N Wabash Ave Ste 1116-Lm
Chicago, IL 60602-1903

Phone 312-800-3395 · Fax 866-776-7795

Mailing address

111 N Wabash Ave Ste 1116-Lm
Chicago, IL 60602-1903

Phone 312-809-8380 · Fax 866-776-7795

Authorized official

Aram Honore
Lab Director
3128098380

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