Organization
STATE SCIENTIFIC LAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAHAD GAFFOOR (PRESIDENT)
(773) 818-5550
Entity
Organization
Contact information
Practice address
1550 N MANNHEIM RD STE C, STONE PARK, IL 60165-1300
(708) 223-0457
Mailing address
1550 N MANNHEIM RD STE C, STONE PARK, IL 60165-1300
(708) 223-0457
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
10/22/2021
Last updated
11/05/2021
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