Provider Demographics
NPI:1508502469
Name:ELITE SOLUTIONS LABORATORIES & SCREENINGS LLC
Entity Type:Organization
Organization Name:ELITE SOLUTIONS LABORATORIES & SCREENINGS LLC
Other - Org Name:ELITE SOLUTIONS LABORATORIES
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAQUANTA
Authorized Official - Middle Name:
Authorized Official - Last Name:VANDERPOOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-554-9269
Mailing Address - Street 1:701 ANDERSON RD N # 99
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-2709
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:701 ANDERSON RD N # 99
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-2709
Practice Address - Country:US
Practice Address - Phone:877-711-2119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-12
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory