Provider Demographics
NPI:1497416861
Name:A 1 LAB INC
Entity Type:Organization
Organization Name:A 1 LAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VENKATA R
Authorized Official - Middle Name:
Authorized Official - Last Name:BALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-327-6474
Mailing Address - Street 1:2142 W ROSEMONT AVE APT 4B
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-2161
Mailing Address - Country:US
Mailing Address - Phone:980-327-6474
Mailing Address - Fax:
Practice Address - Street 1:2142 W ROSEMONT AVE APT 4B
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-2161
Practice Address - Country:US
Practice Address - Phone:980-327-6474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-06
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RM2200XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyMedical LaboratoryGroup - Multi-Specialty
No291U00000XLaboratoriesClinical Medical LaboratoryGroup - Multi-Specialty