Contract Details
Facility name
Dcl Medical Laboratories, LLC
Provider ID
P000006039
Tax ID
260844836
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
1520 Momentum Pl
Chicago, IL 60689
United States
County
Cook
Phone
3178720116 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Laboratory Service Provider
Map
Address