Organization
RT PCR TEST NEAR ME INC
Active
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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