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South Chicago Lab Limited
Clinical Laboratory Director (Non-physician) in Chicago Ridge, Illinois
NPI 1679165039

South Chicago Lab Limited is a Clinical Laboratory Director (Non-physician) based in Chicago Ridge, IL and is specialized in Clinical Laboratory Director, Non-physician. South Chicago Lab Limited practices in Chicago Ridge, IL. The NPI Number for South Chicago Lab Limited is 1679165039 and holds a License No. (Illinois).

The current practice location address for South Chicago Lab Limited is 10500 Southwest Hwy Ste C, Chicago Ridge, IL and can be reached out via phone at 815-440-9285.

Location: 10500 Southwest Hwy Ste C, Chicago Ridge, IL, 60415-2805
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1679165039
Provider Name
South Chicago Lab Limited
Credential
Provider Entity Type
Organization
Address
10500 Southwest Hwy Ste C, Chicago Ridge, IL, 60415-2805
Phone Number
815-440-9285
Fax Number
Provider Enumeration Date
02/08/2021
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
NA 05 IL
institution
Provider Business Practice Location Address Details
Address
10500 Southwest Hwy Ste C
City
Chicago Ridge
State
Illinois
Zip
60415-2805
Phone Number
815-440-9285
Fax Number
person
Provider Business Mailing Address Details
Address
10500 Southwest Hwy Ste C
City
Chicago Ridge
State
Illinois
Zip
60415-2805
Phone Number
815-440-9285
Fax Number
person
Provider's Taxonomy Details 1
Type
Technologists, Technicians & Other Technical Service Providers
Classification
Technician, Pathology
Speciality
Clinical Laboratory Director, Non-physician
Taxonomy
247ZC0005X
License No.
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Definition
An individual who is state-licensed as a clinical laboratory director and meets the qualifications in the Clinical Laboratory Improvement Amendments of 1988 for non-physicians (non-MD/DO) as defined in the CFR 42 Part 493.1405.
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