MEDICARE: LABORATORY SERVICES 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	:	1881323160
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LABORATORY SERVICES LLC

Provider Business Mailing Address
First Line	:	2821 S PARKER RD PH 25
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80014-2718
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3810 IRVING ST STE B
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80211-1956
Country	:	US
Telephone Number	:	214-960-5690
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ANDREW W KWONG
Credential	:
Telephone Number	:	214-960-5690

Provider Enumeration Date	:	06/10/2022
Last Update Date	:	06/10/2022

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Directions to “LABORATORY SERVICES LLC ” Practice Location

Language	Start Address	Practice Location

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