Organization
OMNI LABORATORY SERVICES
Active
Organization
OMNI LABORATORY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GULAM TAHA SIDDIQUE (MANAGER)
(773) 200-8059
Entity
Organization
Contact information
Practice address
5866 N LINCOLN AVE, STE 103, CHICAGO, IL 60659-4632
(773) 200-8059
Mailing address
5866 N LINCOLN AVE, STE 103, CHICAGO, IL 60659-4632
(773) 200-8059
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
08/13/2018
Last updated
03/13/2024
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