Contract Details
Facility name
Unilab Inc
Provider ID
P000005594
NPI
1912000308
Tax ID
363766002
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
418 North Austin Blvd Suite 2A
Oak Park, IL 60302
United States
County
Cook
Phone
7088481556 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Laboratory Service Provider
Map
Address