Modern Laboratory Incorporated

LBN: Modern Laboratory Incorporated
Modern Laboratory Incorporated is an health care organization with primary practice located at 1793 Bloomingdale Rd Ste 1 , Glendale Heights IL 60139-3800. The organization recently has only one registered license in Laboratories / Clinical Medical Laboratory, which is considered as the primary health care specialty. Modern Laboratory Incorporated can be contacted via phone (630) 933-8101, or through Ghose, Prasanta K via phone (630) 933-8101.

Contact Information

Primary practice address
1793 Bloomingdale Rd Ste 1 Glendale Heights IL 60139-3800
Phone: (630) 933-8101
Fax: (630) 933-8105
Website:
Map and Directions
Authorized official contact:
Name: Ghose, Prasanta K
Phone: (630) 933-8101

Health care specialties

SpecialtyCodeLicense #State
Laboratories / Clinical Medical Laboratory 291U00000X 291U00000X Illinois

Profile Details

NPI number 1366612731
LBN Legal business name Modern Laboratory Incorporated
DBA Doing business as
Authorized official Ghose, Prasanta K
Entity Organization
Organization subpart 1 No
Enumeration date Mar 3rd, 2008
Last updated Sep 18th, 2014 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366612731 NPPES
Illinois Other 14D1079331 CLIA
Illinois Other 216691 CLIA

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