Provider Demographics
NPI:1710632765
Name:QUALITY COVID CONTROL
Entity Type:Organization
Organization Name:QUALITY COVID CONTROL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MACIEJ
Authorized Official - Middle Name:
Authorized Official - Last Name:KOSIARSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-595-8901
Mailing Address - Street 1:4976 HONONEGAH RD
Mailing Address - Street 2:
Mailing Address - City:ROSCOE
Mailing Address - State:IL
Mailing Address - Zip Code:61073-7778
Mailing Address - Country:US
Mailing Address - Phone:312-623-7014
Mailing Address - Fax:
Practice Address - Street 1:4976 HONONEGAH RD
Practice Address - Street 2:
Practice Address - City:ROSCOE
Practice Address - State:IL
Practice Address - Zip Code:61073-7778
Practice Address - Country:US
Practice Address - Phone:312-623-7014
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory