Provider Demographics
NPI:1053819722
Name:L. MEDICINE LABS, LLC
Entity Type:Organization
Organization Name:L. MEDICINE LABS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUKASICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-216-5723
Mailing Address - Street 1:2160 S 1ST AVE RM 1711
Mailing Address - Street 2:
Mailing Address - City:MAYWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60153-3328
Mailing Address - Country:US
Mailing Address - Phone:708-216-8686
Mailing Address - Fax:708-216-8059
Practice Address - Street 1:3231 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-3471
Practice Address - Country:US
Practice Address - Phone:708-783-0737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-29
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory