Organization
O'HARE CLINICAL LAB SERVICES INC
Active
Other names
OCL Labs, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MOHAMED SIRAJUDEEN (PRESIDENT)
(773) 552-1355
Entity
Organization
Contact information
Practice address
4909 W DIVISION ST STE 303, CHICAGO, IL 60651-3161
(800) 839-2095
(800) 761-3075
Mailing address
1420 RENAISSANCE DR STE 206, PARK RIDGE, IL 60068-1342
(800) 839-2095
(800) 761-3075
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
14D1051792
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09932450
B/C B/S IL
IL
01
—
P00397462
R/R MEDICARE
IL
Enumeration date
06/18/2006
Last updated
02/11/2022
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