Organization
UNITED CLINICAL LAB LLC
Active
Organization
UNITED CLINICAL LAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAIFIDEAN OTTALLAH (CEO/OWNER)
(440) 455-1444
Entity
Organization
Contact information
Practice address
4859 DOVER CENTER RD STE 12, NORTH OLMSTED, OH 44070-3189
(440) 455-1444
Mailing address
4859 DOVER CENTER RD STE 12, NORTH OLMSTED, OH 44070-3189
(440) 455-1444
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36D2257969
CLIA
OH
Enumeration date
05/04/2022
Last updated
05/20/2022
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