| Southwest Direct Diagnostic Laboratory | |
|
301 W Roosevelt Rd Ste J Wheaton IL 60187-5009 | |
| (346) 771-1189 | |
| (346) 771-1189 |
| Full Name | Southwest Direct Diagnostic Laboratory |
|---|---|
| Speciality | Clinic/center |
| Location | 301 W Roosevelt Rd Ste J, Wheaton, Illinois |
| Authorized Official Name and Position | Romaan Ali Baig Mirza (DME) |
| Authorized Official Contact | 3467711189 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southwest Direct Diagnostic Laboratory 301 W Roosevelt Rd Ste J Wheaton IL 60187-5009 Ph: (346) 771-1189 | Southwest Direct Diagnostic Laboratory 301 W Roosevelt Rd Ste J Wheaton IL 60187-5009 Ph: (346) 771-1189 |
| NPI Number | 1740109123 |
|---|---|
| Provider Enumeration Date | 07/10/2026 |
| Last Update Date | 09/15/2026 |
| Certification Date | 09/15/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740109123 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
| 261QP2300X | Clinic/center - Primary Care | () | Secondary |
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