Provider Demographics
NPI:1225742158
Name:SULMED LABS LLC
Entity Type:Organization
Organization Name:SULMED LABS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDRIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SULTAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-874-8941
Mailing Address - Street 1:851 NE 1ST AVE UNIT 2023
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33132-1844
Mailing Address - Country:US
Mailing Address - Phone:224-360-5664
Mailing Address - Fax:
Practice Address - Street 1:920 N RIDGE AVE STE A4
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-1226
Practice Address - Country:US
Practice Address - Phone:224-360-5664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory