MEDICARE: TOTAL LAB SOLUTIONS 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	:	1750018370
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL LAB SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	1250 STEPHENSON HWY STE 200
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48083-1115
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1250 STEPHENSON HWY STE 200
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48083-1115
Country	:	US
Telephone Number	:	248-800-6626
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	RENI CHACKO GEORGE
Credential	:
Telephone Number	:	248-800-6626

Provider Enumeration Date	:	08/03/2022
Last Update Date	:	02/09/2026

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