Organization
LIFELINE BIOSCIENCES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NADEEM KHAN (OWNER)
(331) 356-4264
Entity
Organization
Contact information
Practice address
2777 FINLEY RD STE 19, DOWNERS GROVE, IL 60515-1053
(331) 356-4264
Mailing address
2777 FINLEY RD STE 19, DOWNERS GROVE, IL 60515-1053
(331) 356-4264
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14D2252343
CLIA
IL
Enumeration date
02/28/2022
Last updated
11/29/2023
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