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General NPI Number Information
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NPI Number | 1477173847
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Entity Type | Organization
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Legal Business Name | AUGUSTUS LABS LLC
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Dates
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Enumeration Date | 04/25/2020
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 2801 FINLEY RD STE 101
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-1039
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Country | US
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Telephone | 630-672-8100
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Fax | 630-672-8100
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Provider Business Mailing Address
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Address Line | 2801 FINLEY RD STE 101
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-1039
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Country | US
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Telephone | 630-672-8100
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Fax | 630-672-8100
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Authorized Official
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Title or Position | OWNER
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Name | JABER NIKNAM
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Credential |
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Telephone | 832-758-2616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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