Organization
ELITE MEDICAL LABORATORY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RONNISHA SHAQUANA BANKS CPT (OWNER)
(779) 475-1603
Entity
Organization
Contact information
Practice address
5435 EMERSON WAY STE 405A-B, INDIANAPOLIS, IN 46226-1466
(317) 827-0011
Mailing address
5435 EMERSON WAY STE 405A-B, INDIANAPOLIS, IN 46226-1466
(317) 827-0011
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
—
—
Other
Enumeration date
10/23/2023
Last updated
10/23/2023
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