Provider Demographics
NPI:1518637982
Name:EXCEL LABS CO
Entity Type:Organization
Organization Name:EXCEL LABS CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SURESH
Authorized Official - Middle Name:
Authorized Official - Last Name:SRINIVASAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-998-3456
Mailing Address - Street 1:5120 BELMONT RD STE E
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-4333
Mailing Address - Country:US
Mailing Address - Phone:630-998-3456
Mailing Address - Fax:
Practice Address - Street 1:5120 BELMONT RD STE E
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-4333
Practice Address - Country:US
Practice Address - Phone:630-998-3456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-17
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory