Provider Demographics
NPI:1073401956
Name:DALLY DIAGNOSTICS INC
Entity type:Organization
Organization Name:DALLY DIAGNOSTICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAKIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-499-8375
Mailing Address - Street 1:4245 S BEECH DALY ST STE 201
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48125-1576
Mailing Address - Country:US
Mailing Address - Phone:425-499-8375
Mailing Address - Fax:
Practice Address - Street 1:4245 S BEECH DALY ST STE 201
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48125-1576
Practice Address - Country:US
Practice Address - Phone:425-499-8375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-27
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory