Organization
UNIVERSITY LAB CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAM SHIMI (DIRECTOR OF OPERATIONS)
(630) 257-9500
Entity
Organization
Contact information
Practice address
603 COUNTRY CLUB DR STE E, BENSENVILLE, IL 60106-1329
(630) 521-9708
(630) 521-9714
Mailing address
603 COUNTRY CLUB DR STE E, BENSENVILLE, IL 60106-1329
(630) 521-9708
(630) 521-9714
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
14D2142429
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14D2142429
CLIA
IL
Enumeration date
03/01/2018
Last updated
11/15/2018
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