Provider Demographics
NPI:1487258943
Name:LAB ELITE LLC
Entity type:Organization
Organization Name:LAB ELITE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NIKOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:NOZINIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-504-4808
Mailing Address - Street 1:5824 N. NORTHWEST HIGHWAY
Mailing Address - Street 2:5824 N. NORTHWEST HIGHWAY CHICAGO, IL 60631
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631
Mailing Address - Country:US
Mailing Address - Phone:312-504-4808
Mailing Address - Fax:
Practice Address - Street 1:5824 N NORTHWEST HWY
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-2641
Practice Address - Country:US
Practice Address - Phone:312-504-4808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory