Provider Demographics
NPI:1679384267
Name:SCIENTIFIC DIAGNOSTIC SERVICES INC
Entity type:Organization
Organization Name:SCIENTIFIC DIAGNOSTIC SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FAZAL
Authorized Official - Middle Name:AHMED
Authorized Official - Last Name:AHMEDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-341-8298
Mailing Address - Street 1:2639 W DEVON AVE STE LL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-1812
Mailing Address - Country:US
Mailing Address - Phone:773-341-8298
Mailing Address - Fax:
Practice Address - Street 1:2639 W DEVON AVE STE LL
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-1812
Practice Address - Country:US
Practice Address - Phone:773-341-8298
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory