Provider Demographics
NPI:1891467460
Name:996
Entity Type:Organization
Organization Name:996
Other - Org Name:996 LABS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LAB DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ARAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HONORE
Authorized Official - Suffix:
Authorized Official - Credentials:PHLEBOTOMIST
Authorized Official - Phone:312-809-8380
Mailing Address - Street 1:111 N WABASH AVE STE 1116-LM
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-1903
Mailing Address - Country:US
Mailing Address - Phone:312-809-8380
Mailing Address - Fax:866-776-7795
Practice Address - Street 1:111 N WABASH AVE STE 1116-LM
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-1903
Practice Address - Country:US
Practice Address - Phone:312-800-3395
Practice Address - Fax:866-776-7795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-01
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical LaboratoryGroup - Single Specialty