MEDICARE: CENTER GROUP HOLDINGS 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	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1710834676
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTER GROUP HOLDINGS LLC

Provider Business Mailing Address
First Line	:	27882 MEADOW DR UNIT 108
Second Line	:
City	:	EVERGREEN
State	:	CO
Zip	:	80439-8335
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	27882 MEADOW DR UNIT 108
Second Line	:
City	:	EVERGREEN
State	:	CO
Zip	:	80439-8335
Country	:	US
Telephone Number	:	310-430-0806
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DEEPAK PARWATIKAR
Credential	:
Telephone Number	:	310-430-0806

Provider Enumeration Date	:	03/11/2026
Last Update Date	:	03/11/2026

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