Provider Demographics
NPI:1255071387
Name:CLINICARE LAB LTD
Entity type:Organization
Organization Name:CLINICARE LAB LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YASER
Authorized Official - Middle Name:
Authorized Official - Last Name:DAHKLALLAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-229-1280
Mailing Address - Street 1:11S270 S JACKSON ST STE 103
Mailing Address - Street 2:
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-6829
Mailing Address - Country:US
Mailing Address - Phone:630-229-1280
Mailing Address - Fax:
Practice Address - Street 1:11S270 S JACKSON ST STE 103
Practice Address - Street 2:
Practice Address - City:BURR RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60527-6829
Practice Address - Country:US
Practice Address - Phone:630-229-1280
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory