# EASY LAB TECH, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093475527
- **Authorized official:** AIGNER MILES (BUSINESS OPERATIONS MANAGER)
- **Authorized official phone:** (314) 562-6552

## Contact information

- **Practice address:** 2203 N CENTER ST, MARYVILLE, IL 62062-2024
- **Practice address phone:** (618) 772-7222
- **Mailing address:** 2203 N CENTER ST, MARYVILLE, IL 62062-2024

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/24/2021
- **Last updated:** 12/24/2021