Organization
DIAGNOSTIC MEDICAL LABORATORY, INC.
Active
Other names
Diagnostic Medical Laboratory, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH S TENGBEH SR. MD. (LABORATORY DIRECTOR AND OWNER)
(773) 255-4959
Entity
Organization
Contact information
Practice address
4554 N. BROADWAY STREET, SUITE 317, CHICAGO, IL 60640-5642
(773) 255-4959
(773) 506-0269
Mailing address
4554 N. BROADWAY STREET, SUITE 317, CHICAGO, IL 60640-5642
(773) 255-4959
(773) 506-0269
Taxonomy
Speciality
Code
Description
License number
State
246QL0900X
Laboratory Management Specialist/Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20388576001
—
IL
Enumeration date
02/12/2007
Last updated
02/22/2012
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