Provider Demographics
NPI:1912658287
Name:LIFE CARE LABS INC
Entity type:Organization
Organization Name:LIFE CARE LABS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SIRAJ
Authorized Official - Middle Name:M
Authorized Official - Last Name:SYED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-865-9587
Mailing Address - Street 1:5514 W LAWRENCE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-3412
Mailing Address - Country:US
Mailing Address - Phone:773-865-9587
Mailing Address - Fax:
Practice Address - Street 1:5514 W LAWRENCE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-3412
Practice Address - Country:US
Practice Address - Phone:773-865-9587
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory