Provider Demographics
NPI:1720206253
Name:HWY CLINICAL LABORATORY SERVICES
Entity Type:Organization
Organization Name:HWY CLINICAL LABORATORY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TUM
Authorized Official - Middle Name:DINH
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-704-2227
Mailing Address - Street 1:3829 S OLD HIGHWAY 94
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63304-2824
Mailing Address - Country:US
Mailing Address - Phone:847-704-2227
Mailing Address - Fax:
Practice Address - Street 1:855 E GOLF RD
Practice Address - Street 2:SUITE 2140
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-5222
Practice Address - Country:US
Practice Address - Phone:847-704-2227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory