Provider Demographics
NPI:1770346637
Name:ELITE LAB SOLUTIONS LLC
Entity type:Organization
Organization Name:ELITE LAB SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TYHESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-426-2695
Mailing Address - Street 1:6044 MOJAVE DR
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-3543
Mailing Address - Country:US
Mailing Address - Phone:469-381-5778
Mailing Address - Fax:
Practice Address - Street 1:10440 N CENTRAL EXPY STE 800
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-2264
Practice Address - Country:US
Practice Address - Phone:972-426-2685
Practice Address - Fax:972-435-4453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-02
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty