Provider Demographics
NPI:1013558709
Name:CONVENIENT LABORATORIES LLC
Entity Type:Organization
Organization Name:CONVENIENT LABORATORIES LLC
Other - Org Name:CONVELABS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICODEMME
Authorized Official - Middle Name:
Authorized Official - Last Name:JEAN-BAPTISTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-527-9169
Mailing Address - Street 1:183 STERLING SPRINGS LN
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-3856
Mailing Address - Country:US
Mailing Address - Phone:407-775-9705
Mailing Address - Fax:941-251-8467
Practice Address - Street 1:183 STERLING SPRINGS LN
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-3856
Practice Address - Country:US
Practice Address - Phone:407-775-9705
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONVELABS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-10-03
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory