Provider Demographics
NPI:1154515377
Name:MEDLAB INC
Entity type:Organization
Organization Name:MEDLAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ARSHADULLAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SYED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-677-5272
Mailing Address - Street 1:35 GAYLORD ST
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE VILLAGE
Mailing Address - State:IL
Mailing Address - Zip Code:60007-1104
Mailing Address - Country:US
Mailing Address - Phone:847-979-8184
Mailing Address - Fax:847-979-8284
Practice Address - Street 1:35 GAYLORD ST
Practice Address - Street 2:
Practice Address - City:ELK GROVE VILLAGE
Practice Address - State:IL
Practice Address - Zip Code:60007-1104
Practice Address - Country:US
Practice Address - Phone:847-979-8184
Practice Address - Fax:847-979-8284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL14D1071933291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL215612OtherMEDICARE
IL14D1071933OtherCLIA