Provider Demographics
NPI:1518613595
Name:SAMP LABS LLC
Entity Type:Organization
Organization Name:SAMP LABS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHETAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SONI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-962-1125
Mailing Address - Street 1:18000 JEFFERSON PARK RD STE 101
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3440
Mailing Address - Country:US
Mailing Address - Phone:847-962-1125
Mailing Address - Fax:
Practice Address - Street 1:18000 JEFFERSON PARK RD STE 101
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-3440
Practice Address - Country:US
Practice Address - Phone:847-962-1125
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-28
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory