Provider Demographics
NPI:1699417667
Name:RAPID DIAGNOSTICS MEDICAL LABORATORY LLC
Entity type:Organization
Organization Name:RAPID DIAGNOSTICS MEDICAL LABORATORY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:HUSSINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HIDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-543-3660
Mailing Address - Street 1:25106 W 6 MILE RD
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48240-2706
Mailing Address - Country:US
Mailing Address - Phone:313-543-3660
Mailing Address - Fax:
Practice Address - Street 1:25106 W 6 MILE RD
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48240-2706
Practice Address - Country:US
Practice Address - Phone:313-543-3660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-11
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory