Organization
GLASS CLINICAL LABS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KOLAVENNU V KRISHNAIAH PH.D (DIRECTOR)
(708) 991-0714
Entity
Organization
Contact information
Practice address
18238 AIDA CT, HOMEWOOD, IL 60430-2867
(708) 991-0714
Mailing address
18238 AIDA CT, HOMEWOOD, IL 60430-2867
(708) 991-0714
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
001
IL
Other
Enumeration date
03/06/2007
Last updated
07/21/2022
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