Aqsa Lab Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

14D2134131 Issued in IL

Legal business name

AQSA LAB INC

Practice address

10322 S Harlem Ave
Palos Hills, IL 60465-2036

Phone

(708) 576-8881

NPI assigned

Nov 27, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mohamad Y Khlifeh

Title

Lab Director

Phone

(708) 576-8881

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mohamad Y Khalifeh

  • Clinical Medical Laboratory
  • Palos Hills, IL
  • NPI 1215446034
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1511740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511740800000",
    "number": "1295249498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10322 S HARLEM AVE",
            "city": "PALOS HILLS",
            "state": "IL",
            "postal_code": "604652036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10322 S HARLEM AVE",
            "city": "PALOS HILLS",
            "state": "IL",
            "postal_code": "604652036",
            "telephone_number": "708-576-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AQSA LAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-27",
        "last_updated": "2017-11-27",
        "status": "A",
        "authorized_official_last_name": "KHLIFEH",
        "authorized_official_first_name": "MOHAMAD",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "LAB DIRECTOR",
        "authorized_official_telephone_number": "708-576-8881"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "IL",
            "license": "14D2134131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Palos Hills, IL
• Providers in Palos Hills, IL by specialty
• Clinical Medical Laboratory in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.