Modern Laboratory Incorporated in Glendale Heights - Clinical Medical Laboratory
Modern Laboratory Incorporated - NPI 1366612731
Modern Laboratory Incorporated is a Clinical Medical Laboratory in Glendale Heights, Illinois. Modern Laboratory Incorporated practices all healthcare services and medical treatments related to Clinical Medical Laboratory. The NPI Number for Modern Laboratory Incorporated is 1366612731. The last update date is 2014-09-18.
Modern Laboratory Incorporated's current location address is 1793 Bloomingdale Rd Ste 1, Glendale Heights, Illinois. You can contact this provider via phone number 6309338101 and fax number 6309338105. The mailing address for Modern Laboratory Incorporated is 1793 Bloomingdale Rd Ste 1, Glendale Heights, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Modern Laboratory Incorporated |
|---|---|
| Address | 1793 Bloomingdale Rd Ste 1, Glendale Heights, Illinois |
| Phone Number | 6309338101 |
| Fax Number | 6309338105 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Ghose K Prasanta |
| Telephone Number | 6309338101 |
NPI Number Detail
| NPI Number | 1366612731 |
|---|---|
| Provider Enumeration Date | 2008-03-03 |
| Last Updated Date | 2014-09-18 |
Provider Mailing Address Detail
| Address | 1793 Bloomingdale Rd Ste 1 |
|---|---|
| City | Glendale Heights |
| State | Illinois (IL) |
| Post Code | 601393800 |
| Phone Number | 6309338101 |
| Fax Number | 6309338105 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical Medical Laboratory |
|---|---|
| Taxonomy | 291U00000X |
| Licence No | 291U00000X |
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Definition: (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purp |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 14D1079331 | IL | CLIA | |
| 216691 | IL | PTAN |
Post Comment/ Review Below
What is the unique identifier code issued to Modern Laboratory Incorporated by the Centers for Medicare & Medicaid Services?
The Modern Laboratory Incorporated has been assigned the NPI (National Provider Identifier) 1366612731. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Modern Laboratory Incorporated is located?
The Modern Laboratory Incorporated is situated at the following address: 1793 Bloomingdale Rd Ste 1, Glendale Heights, IL, 601393800.
What is the Modern Laboratory Incorporated's specialty and taxonomy code?
The Modern Laboratory Incorporated's specialty is Clinical Medical Laboratory, and the corresponding taxonomy code is 291U00000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1366612731 to Modern Laboratory Incorporated?
The Centers for Medicare & Medicaid Services assigned the 1366612731 to Modern Laboratory Incorporated on 2008-03-03.
When was the information related to Modern Laboratory Incorporated most recently updated or refreshed?
The details pertaining to the Modern Laboratory Incorporated, including its address, specialty, and other relevant information, were last updated or refreshed on 2014-09-18.