Healthcare Provider Details

I. General information

NPI: 1922911239
Provider Name (Legal Business Name): RINCON LABS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2026
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 BROOKS AVE
VENICE CA
90291-3424
US

IV. Provider business mailing address

717 BROOKS AVE
VENICE CA
90291-3424
US

V. Phone/Fax

Practice location:
  • Phone: 608-630-0291
  • Fax: 209-215-0487
Mailing address:
  • Phone: 608-630-0291
  • Fax: 209-215-0487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: CONOR FREEMAN FOLEY
Title or Position: CEO
Credential:
Phone: 608-630-0291