Healthcare Provider Details

I. General information

NPI: 1205751732
Provider Name (Legal Business Name): LEGENDARY LABORATORY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 W LAFAYETTE BLVD # 309
DETROIT MI
48216-1926
US

IV. Provider business mailing address

1515 W LAFAYETTE BLVD # 309
DETROIT MI
48216-1926
US

V. Phone/Fax

Practice location:
  • Phone: 313-228-7762
  • Fax:
Mailing address:
  • Phone: 313-228-7762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State

VIII. Authorized Official

Name: MS. COREYCE DANYELL CURRY
Title or Position: OWNER
Credential:
Phone: 313-228-7762