Healthcare Provider Details

I. General information

NPI: 1457288375
Provider Name (Legal Business Name): BIOGENESIS LABORATORIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 LAREDO ST # B102
AURORA CO
80011-5838
US

IV. Provider business mailing address

1400 LAREDO ST # B102
AURORA CO
80011-5838
US

V. Phone/Fax

Practice location:
  • Phone: 847-903-5197
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: SHAKIL GHAFOOR
Title or Position: PRESIDENT
Credential:
Phone: 847-903-5197