SOUTHSHORE MEDI LAB INC
NPI 1073978631
Clinical Medical Laboratory in Chicago, IL

Active since December 28, 2015
4651 W 79TH ST STE 204, CHICAGO, IL 60652(773) 585-0480(773) 585-0482 Get Directions Write a Review

NPPES record last updated: December 28, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Southshore Medi Lab Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHSHORE MEDI LAB INC (NPI 1073978631) is a healthcare organization registered as a clinical medical laboratory in Chicago, Illinois and active in the NPI registry since December 2015. The organization lists Ashfaq Muhammad, President, as its authorized official.

NPPES Registry Identity

NPI1073978631
Entity TypeOrganization
Primary Taxonomy291U00000X
Legal Business NameSOUTHSHORE MEDI LAB INC
Location Address4651 W 79TH ST STE 204Chicago, IL 60652-1775
Mailing Address4651 W 79th St Ste 204Chicago, IL 60652-1775 · (773) 585-0480 · Fax (773) 585-0482
Fax(773) 585-0482
Organization SubpartNo
Authorized OfficialAshfaq MuhammadPresident · (773) 585-0480
Enumeration DateDecember 28, 2015
NPI 1073978631 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinical Medical LaboratoryLaboratories
Taxonomy Code291U00000X
License Licensed in IL · 14D2104608
Definition
(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.
4651 W 79TH ST STE 204, Chicago, IL 60652

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southshore Medi Lab Inc's NPI number?

The NPI number for Southshore Medi Lab Inc is 1073978631. It was assigned to this organization in the NPPES registry on December 28, 2015.

Where is Southshore Medi Lab Inc located?

Southshore Medi Lab Inc is located at 4651 W 79th St Ste 204, Chicago, IL 60652. The listed phone number is (773) 585-0480.

What is Southshore Medi Lab Inc's specialty?

The primary specialty registered for this NPI is Clinical Medical Laboratory with taxonomy code 291U00000X.

When was this NPI record last updated?

The NPPES record for Southshore Medi Lab Inc was last updated on December 28, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.