Provider Demographics
NPI:1609563501
Name:AMELIORATE LABORATORIES LLC
Entity Type:Organization
Organization Name:AMELIORATE LABORATORIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SOPHIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GWELO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-335-9784
Mailing Address - Street 1:7220 N 16TH ST STE J
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-5253
Mailing Address - Country:US
Mailing Address - Phone:214-335-9784
Mailing Address - Fax:970-695-7751
Practice Address - Street 1:7220 N 16TH ST STE J
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-5253
Practice Address - Country:US
Practice Address - Phone:214-335-9784
Practice Address - Fax:970-695-7751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory