Brightpath Lab LLC
Organization Active NPI Clinical Medical Laboratory · Lockport, IL
NPI 1932069663 · NPPES record last updated Aug 10, 2026
Key facts
- NPI
- 1932069663
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Medical Laboratory 291U00000X
- Legal business name
- BRIGHTPATH LAB LLC
- Practice address
- 14400 S Archer Ave Unit 2
Lockport, IL 60441-5806 - Phone
- (320) 577-7824
- NPI assigned
- Nov 14, 2025
- Organization subpart
- No
Authorized official
- Name
- Saikumar Pulimamidi
- Title
- Ceo
- Phone
- (320) 577-7824
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D2332956 | Brightpath Lab LLC | Registration | Oct 27, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20260109000433 | IL | Part B Supplier - Independent Clinical Laboratory | 9133605132 | Practice locations: Lockport, IL |
National Provider Directory
Locations
14400 S Archer Ave
Unit 2
Lockport, IL 60441
Phone (320) 577-7824
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Yes |
Addresses
Primary practice location
14400 S Archer Ave Unit 2
Lockport, IL 60441-5806
Mailing address
14400 S Archer Ave Unit 2
Lockport, IL 60441-5806
Phone (320) 577-7824
Other providers in Lockport, IL
- Elizabeth Frances Blaha
- Gregory Paul Bobak
- Brianne Kathryn Boettcher
- Thomas Richard Brescia
- Bridges to a New Day,NFP
- Jennifer Britt
- Anna Maris Labrado Briz
- Lisa Michele Brown
- Brian Bruckner
- Kimberly Ann Brumley
All providers in Lockport, IL · Clinical Medical Laboratory in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.