Provider Demographics
NPI:1831842434
Name:K LABORATORY LLC
Entity type:Organization
Organization Name:K LABORATORY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/MEMBRER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FOURTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-392-2901
Mailing Address - Street 1:1527 TIENSTRA CT
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-1352
Mailing Address - Country:US
Mailing Address - Phone:773-392-2901
Mailing Address - Fax:
Practice Address - Street 1:17901 GOVERNORS HWY STE 204
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-1146
Practice Address - Country:US
Practice Address - Phone:773-392-2901
Practice Address - Fax:773-439-2838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-02
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory