PPG Labs LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PPG LABS LLC

Practice address

33 W Roosevelt Rd Ste H
Lombard, IL 60148-4401

Phone

(847) 269-0749

NPI assigned

Jan 3, 2022

Last updated

Dec 17, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Khaled Altawafshah

Title

Ceo/Owner

Phone

(630) 921-1078

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1641168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765929600000",
    "number": "1255092250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 W ROOSEVELT RD STE H",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601484401",
            "telephone_number": "844-774-5227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 W ROOSEVELT RD STE H",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601484401",
            "telephone_number": "847-269-0749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PPG LABS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-03",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A",
        "authorized_official_last_name": "ALTAWAFSHAH",
        "authorized_official_first_name": "KHALED",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "630-921-1078"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Lombard, IL
• Providers in Lombard, IL by specialty
• Clinical Medical Laboratory in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.