Provider Demographics
NPI:1194505487
Name:ELITE STAT LAB SERVICES LLC
Entity type:Organization
Organization Name:ELITE STAT LAB SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ARTI
Authorized Official - Middle Name:
Authorized Official - Last Name:PURWAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-433-9420
Mailing Address - Street 1:1500 LOYOLA DR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-1777
Mailing Address - Country:US
Mailing Address - Phone:224-433-9420
Mailing Address - Fax:708-400-8172
Practice Address - Street 1:1500 LOYOLA DR
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60565-1777
Practice Address - Country:US
Practice Address - Phone:772-815-0123
Practice Address - Fax:708-400-8172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-03
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Multi-Specialty