Healthcare Provider Details

I. General information

NPI: 1184498545
Provider Name (Legal Business Name): EXPRESSCARE LABS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2023
Last Update Date: 11/13/2023
Certification Date: 11/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 W GREENWAY RD STE 225
PHOENIX AZ
85023-4226
US

IV. Provider business mailing address

21021 N 56TH ST APT 3089
PHOENIX AZ
85054-5609
US

V. Phone/Fax

Practice location:
  • Phone: 480-525-0385
  • Fax:
Mailing address:
  • Phone: 575-621-0582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MR. BRIGHT TURAKI
Title or Position: LAB DIRECTOR
Credential: RN
Phone: 575-621-0582