Organization
OMNI DIAGNOSTIC LABORATORY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMED AZHERUDDIN (AUTHORIZED OFFICIAL)
(773) 943-2487
Entity
Organization
Contact information
Practice address
5866 N LINCOLN AVE STE 103, CHICAGO, IL 60659-4632
(773) 574-8743
Mailing address
5866 N LINCOLN AVE STE 103, CHICAGO, IL 60659-4632
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
03/15/2023
Last updated
06/10/2025
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