4Every1 Lab Inc.
Organization Active NPI Clinical Medical Laboratory · Chicago, IL
NPI 1073097184 · NPPES record last updated May 1, 2024
Key facts
- NPI
- 1073097184
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Medical Laboratory 291U00000X
- Legal business name
- 4EVERY1 LAB INC.
- Practice address
- 10723 S Halsted St
Chicago, IL 60628 - Phone
- (773) 612-4344
- NPI assigned
- Sep 24, 2018
- Organization subpart
- No
Authorized official
- Name
- Mr. Adeniyi Kuye
- Title
- President
- Phone
- (773) 612-4344
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D2159532 | 4Every1 Laboratory | Compliance | Apr 10, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190605000252 | IL | Part B Supplier - Independent Clinical Laboratory | 7719229376 | Practice locations: Chicago, IL |
National Provider Directory
Locations
10723 S Halsted St
Chicago, IL 60628
Phone (773) 840-3822
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Yes |
Addresses
Primary practice location
10723 S Halsted St
Chicago, IL 60628
Mailing address
10723 S Halsted St
Chicago, IL 60628-3107
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 1, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.