Organization
LONG TERM CARE LABORATORY, LLC.
Active
Organization
LONG TERM CARE LABORATORY, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAM SHIMI (ADMINSTRATOR)
(630) 422-7802
Entity
Organization
Contact information
Practice address
2458 ELMHURST RD, ELK GROVE VILLAGE, IL 60007-6311
(630) 422-7800
(630) 422-1360
Mailing address
2458 ELMHURST RD, ELK GROVE VILLAGE, IL 60007-6311
(630) 422-7800
(630) 422-1360
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
14D2026754
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14D2026754
CLIA
IL
Enumeration date
12/06/2011
Last updated
08/08/2013
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up