Organization
OPTIMUM FAITH LAB CORP
Active
Organization
OPTIMUM FAITH LAB CORP
Active
Parent organization
OPTIMUM FAITH LAB CORP.
Organization subpart
Yes
Provider details
NPI number
Legal business name
OPTIMUM FAITH LAB CORP.
Authorized official
OPAL MULLINGS (MANAGER)
(224) 610-0434
Entity
Organization
Contact information
Practice address
1109 WASHINGTON ST, WAUKEGAN, IL 60085-5301
(224) 610-0434
(855) 325-1872
Mailing address
1109 WASHINGTON ST, WAUKEGAN, IL 60085-5301
(224) 610-0434
(855) 325-1872
Taxonomy
Speciality
Code
Description
License number
State
332BN1400X
Nursing Facility Supplies (DME)
Primary
—
—
Other
Enumeration date
04/30/2020
Last updated
04/30/2020
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