Southland Home Labs Corp.,

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

SOUTHLAND HOME LABS CORP.,

Practice address

1313 E Sibley Blvd Ste 108
Dolton, IL 60419-2963

Phone

(708) 228-2745

Fax

(708) 880-0702

NPI assigned

Jan 27, 2021

Organization subpart

No

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

Authorized official

Name

Ms. Adetoun Sobitan

Title

Administrator

Phone

(708) 228-2745

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1611705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611705600000",
    "number": "1295326700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 E SIBLEY BLVD STE 108",
            "city": "DOLTON",
            "state": "IL",
            "postal_code": "604192963",
            "telephone_number": "708-228-2745",
            "fax_number": "708-880-0702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 E SIBLEY BLVD STE 108",
            "city": "DOLTON",
            "state": "IL",
            "postal_code": "604192963",
            "telephone_number": "708-228-2745",
            "fax_number": "708-880-0702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHLAND HOME LABS CORP.,",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-27",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A",
        "authorized_official_last_name": "SOBITAN",
        "authorized_official_first_name": "ADETOUN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "708-228-2745",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Dolton, IL
• Providers in Dolton, 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 Jan 27, 2021; 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.