Lab Location Index
NAME LOCATION Lab
STATE - CITY
| LIS LAB NAME | IL - X |
| LIS LAB ID | XYZ-01 |
| OPERATION | |
|---|---|
| STATUS | ACTIVE |
| LOCATION | |
|---|---|
| ADDRESS | X |
| CITY | X |
| STATE | X |
| POSTAL CODE | X |
| REGISTRATION | |
|---|---|
| CLIA ID | X |
| CLIA LAB NAME | X |
| CLIA LAB TYPE | X |
| CLIA CERTIFICATE TYPE | X |
| STAFF | |
|---|---|
| LAB DIRECTOR | X |
| CONTACT | |
|---|---|
| TELEPHONE | X |
| ORDERING PROVIDER | |
|---|---|
| ORDERING PROVIDER ENTITY | X |
| ORDERING ENTITY PHONE NUMBER | X |
| ORDERING PROVIDER ADDRESS | X |
| ORDERING PROVIDER STATE | X |
| ORDERING PROVIDER ZIP | X |
| ORDERING DR. FIRST AND LAST NAME | X |
| ORDERING DR. NPI | X |