Organization
OPTIMUM FAITH LAB CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. OPAL MULLINGS (MANAGER)
(224) 610-0434
Entity
Organization
Contact information
Practice address
1360 N GREEN BAY RD, WAUKEGAN, IL 60085-1104
(224) 610-0434
(855) 325-1872
Mailing address
1360 N GREEN BAY RD, WAUKEGAN, IL 60085-1104
(224) 610-0434
(855) 325-1872
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
IL
Other
Enumeration date
11/15/2016
Last updated
12/10/2020
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