Ifast, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

IFAST, LLC

Doing business as

IFAST Lab Pros

Practice address

5215 N Ironwood Rd Suite 202 PMB 1045
Glendale, WI 53217-4908

Phone

(833) 423-4033

Fax

(833) 423-4033

NPI assigned

Feb 21, 2024

Organization subpart

No

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

Authorized official

Name

K A

Title

CPC/Lab Compliance Specialist

Phone

(833) 423-4033

Specialties & licenses 1

Addresses

Other names 1

• IFAST Lab Pros Doing business as

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

{
    "created_epoch": "1708473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714521600000",
    "number": "1811753536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5215 N IRONWOOD RD SUITE 202 PMB 1045",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532174908",
            "telephone_number": "833-423-4033",
            "fax_number": "833-423-4033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5215 N IRONWOOD RD SUITE 202 PMB 1045",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532174908",
            "telephone_number": "833-423-4033",
            "fax_number": "833-423-4033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IFAST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-21",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A",
        "authorized_official_last_name": "A",
        "authorized_official_first_name": "K",
        "authorized_official_title_or_position": "CPC/LAB COMPLIANCE SPECIALIST",
        "authorized_official_telephone_number": "833-423-4033"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IFAST Lab Pros",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "IFAST Lab Pros",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marlon Connell Hood II
• Stephanie Hood, PHD, BCBA-D
• Tai Marie Hooper, LPC
• Kenneth A Howard, D.C.
• Thomas B Huizenga, M.D.
• Ihc-Urgent Care Services LLC
• Infinity Contracting Inc
• Infinity Healthcare Physicians, S.C.
• Integrated Pain & Joint Care SC
• Integrated Pain and Health Center, SC

• Clinical Medical Laboratory in Glendale, WI
• Providers in Glendale, WI by specialty
• Clinical Medical Laboratory in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.