Provider Demographics
NPI:1437778487
Name:SPECIAL FRIEND LABORATORY LLC
Entity Type:Organization
Organization Name:SPECIAL FRIEND LABORATORY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:A
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:PHLEBOTOMIST
Authorized Official - Phone:773-359-3373
Mailing Address - Street 1:9212 S COMMERCIAL AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60617-4508
Mailing Address - Country:US
Mailing Address - Phone:773-359-3373
Mailing Address - Fax:773-634-8070
Practice Address - Street 1:9212 S COMMERCIAL AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60617-4508
Practice Address - Country:US
Practice Address - Phone:773-359-3373
Practice Address - Fax:773-634-8070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-10
Last Update Date:2020-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory