Provider Demographics
NPI:1780323071
Name:AUSTIN MEDICAL TESTING CORP
Entity type:Organization
Organization Name:AUSTIN MEDICAL TESTING CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMJAD
Authorized Official - Middle Name:
Authorized Official - Last Name:NASER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-747-7348
Mailing Address - Street 1:6112 W LAWRENCE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-2940
Mailing Address - Country:US
Mailing Address - Phone:224-406-1045
Mailing Address - Fax:
Practice Address - Street 1:5362 W LAWRENCE AVE STE CW
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-3659
Practice Address - Country:US
Practice Address - Phone:224-406-1045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AUSTIN MEDICAL TESTING CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-03
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory