Organization
RT PCR TEST NEAR ME INC
Active
Other names
Pro Diagnostics Lab
Organization subpart
No
Provider details
NPI number
Authorized official
FNU ABDUL WAHED (OWNER)
(708) 928-9007
Entity
Organization
Contact information
Practice address
7124 W 83RD ST UNIT D, BRIDGEVIEW, IL 60455-4034
(708) 928-9007
(708) 221-8520
Mailing address
7124 W 83RD ST UNIT D, BRIDGEVIEW, IL 60455-4034
(708) 928-9007
(708) 221-8520
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14D2246682
CLIA CERT OF COMPLIANCE
IL
05
—
F300828629
—
IL
Enumeration date
01/02/2022
Last updated
11/28/2023
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