NPI: 1376685016
Provider Name: DIAGNOSTIC MEDICAL LABORATORY, INC.
Doing Business As: DIAGNOSTIC MEDICAL LABORATORY, INC.
Classification: Specialist/Technologist, Pathology - 246QL0900X
Entity Type: Organization
Specialization: Laboratory Management
Address:
4554 N. BROADWAY STREET
SUITE 317
CHICAGO, IL
ZIP 60640
Phone: (773) 255-4959
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DIAGNOSTIC MEDICAL LABORATORY, INC. is a laboratory management specialist technologist pathology in Chicago, IL. DIAGNOSTIC MEDICAL LABORATORY, INC. NPI is 1376685016. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Diagnostic Medical Laboratory, Inc..
The provider's business location address is:
4554 N. BROADWAY STREET
SUITE 317
CHICAGO, IL
ZIP 60640-642
Phone: (773) 255-4959
Fax: (773) 506-0269
The provider's authorized official is Joseph S Tengbeh .
The authorized official title is Laboratory Director And Owner and has the following contact phone number (773) 255-4959.
The enumeration date for this NPI number is 2/12/2007 and was last updated on 2/22/2012.