Provider Demographics
NPI:1285960088
Name:HUMANA LABS INC
Entity type:Organization
Organization Name:HUMANA LABS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LAB DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BILBIR
Authorized Official - Middle Name:K
Authorized Official - Last Name:DHALIWAL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:219-980-9786
Mailing Address - Street 1:5490 BROADWAY
Mailing Address - Street 2:SUITE #108
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-1675
Mailing Address - Country:US
Mailing Address - Phone:219-980-9786
Mailing Address - Fax:773-762-4333
Practice Address - Street 1:5490 BROADWAY
Practice Address - Street 2:SUITE #108
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-1675
Practice Address - Country:US
Practice Address - Phone:219-980-9786
Practice Address - Fax:773-762-4333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-29
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory