Organization
CENTRAL DIAGNOSTIC LAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASIM ALI MD (OWNER)
(314) 731-6355
Entity
Organization
Contact information
Practice address
456 N NEW BALLAS RD STE 196, SAINT LOUIS, MO 63141-6812
(314) 731-6355
(314) 731-6399
Mailing address
PO BOX 776341, CHICAGO, IL 60677-6341
(314) 731-6355
(314) 731-6399
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
10/05/2015
Last updated
12/09/2015
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