Organization
FAMILY & MEDICINE LABORATORY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMED JAGAHAMA (PRESIDENT)
(312) 931-5763
Entity
Organization
Contact information
Practice address
1544 W 69TH ST, CHICAGO, IL 60636-3449
(312) 931-5763
Mailing address
1544 W 69TH ST, CHICAGO, IL 60636-3449
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
01/06/2025
Last updated
01/06/2025
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