MEDICARE: ZENIX LABS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1053083006
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZENIX LABS LLC

Provider Business Mailing Address
First Line	:	6284 OAKTON ST
Second Line	:
City	:	MORTON GROVE
State	:	IL
Zip	:	60053-2721
Country	:	US
Telephone Number	:	224-534-7368
Fax Number	:

Provider Business Practice Location Address
First Line	:	6284 OAKTON ST
Second Line	:
City	:	MORTON GROVE
State	:	IL
Zip	:	60053-2721
Country	:	US
Telephone Number	:	224-534-7368
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RIFFAT PERVAIZ
Credential	:
Telephone Number	:	224-534-7368

Provider Enumeration Date	:	09/29/2021
Last Update Date	:	03/09/2022

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