Provider Demographics
NPI:1356054795
Name:CONCIERGE LAB SERVICES LLC
Entity type:Organization
Organization Name:CONCIERGE LAB SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:S
Authorized Official - Last Name:KATTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-951-5350
Mailing Address - Street 1:16636 N 58TH ST # 12-2079
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-9228
Mailing Address - Country:US
Mailing Address - Phone:847-951-5350
Mailing Address - Fax:
Practice Address - Street 1:16636 N 58TH ST # 12-2079
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-9228
Practice Address - Country:US
Practice Address - Phone:847-951-5350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-30
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty