Organization
A,GENERAL LAB CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SALMA MIRZA (OFFICE MANAGER)
(224) 595-5100
Entity
Organization
Contact information
Practice address
1793 BLOOMINGDALE RD STE 1, GLENDALE HEIGHTS, IL 60139-3800
(630) 933-9373
(630) 373-4545
Mailing address
1793 BLOOMINGDALE RD STE 1, GLENDALE HEIGHTS, IL 60139-3800
(630) 933-9373
(630) 373-4545
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
364296016001
—
IL
Enumeration date
06/15/2007
Last updated
06/16/2008
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