MEDICARE: LUXPATH ELITE MOBILE LABS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246RP1900X	Phlebotomy Technician

General Provider Information

NPI Number	:	1053264416
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUXPATH ELITE MOBILE LABS LLC

Provider Business Mailing Address
First Line	:	5011 BRECKENRIDGE AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64136-1307
Country	:	US
Telephone Number	:	816-255-7111
Fax Number	:

Provider Business Practice Location Address
First Line	:	5011 BRECKENRIDGE AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64136-1307
Country	:	US
Telephone Number	:	816-255-7111
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SHANTEL BELGRAVE
Credential	:
Telephone Number	:	816-255-7111

Provider Enumeration Date	:	02/17/2026
Last Update Date	:	02/18/2026

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