Provider Demographics
NPI:1215046305
Name:IN-HOME LAB CONNECTION INC.
Entity Type:Organization
Organization Name:IN-HOME LAB CONNECTION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:VALUSEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-842-9000
Mailing Address - Street 1:4064 OLIVINE DR
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-2911
Mailing Address - Country:US
Mailing Address - Phone:952-842-9000
Mailing Address - Fax:952-842-9001
Practice Address - Street 1:4064 OLIVINE DR
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-2911
Practice Address - Country:US
Practice Address - Phone:952-842-9000
Practice Address - Fax:952-842-9001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN352213251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN248120Medicare Oscar/Certification