Provider Demographics
NPI:1588261127
Name:SAFESITE LLC
Entity type:Organization
Organization Name:SAFESITE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LABORATORY DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LUCKEY
Authorized Official - Suffix:
Authorized Official - Credentials:CLS(ASCP)
Authorized Official - Phone:949-375-7775
Mailing Address - Street 1:26660 AGOURA RD
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-1954
Mailing Address - Country:US
Mailing Address - Phone:949-375-7775
Mailing Address - Fax:
Practice Address - Street 1:26660 AGOURA RD
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-1954
Practice Address - Country:US
Practice Address - Phone:949-375-7775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-07
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory