Provider Demographics
NPI:1952449191
Name:HEALTHCHECK LABORATORIES INC.
Entity Type:Organization
Organization Name:HEALTHCHECK LABORATORIES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:YOUNGQUIST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-259-4481
Mailing Address - Street 1:7485 OFFICE RIDGE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55447
Mailing Address - Country:US
Mailing Address - Phone:952-259-4500
Mailing Address - Fax:952-259-4498
Practice Address - Street 1:2810 VICKSBURG LN.
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55447
Practice Address - Country:US
Practice Address - Phone:763-367-7140
Practice Address - Fax:763-367-7145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN24D1047784291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN111958000Medicaid
MN111958000Medicaid