Provider Demographics
NPI:1407743933
Name:ELITE PHLEBOTOMY SERVICES, LLC
Entity type:Organization
Organization Name:ELITE PHLEBOTOMY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:562-303-2924
Mailing Address - Street 1:12495 LIMONITE AVE # 1043
Mailing Address - Street 2:
Mailing Address - City:EASTVALE
Mailing Address - State:CA
Mailing Address - Zip Code:91752-2457
Mailing Address - Country:US
Mailing Address - Phone:562-303-2924
Mailing Address - Fax:562-222-3001
Practice Address - Street 1:6157 FLAGSTAFF DR
Practice Address - Street 2:
Practice Address - City:EASTVALE
Practice Address - State:CA
Practice Address - Zip Code:92880-4611
Practice Address - Country:US
Practice Address - Phone:562-303-2924
Practice Address - Fax:562-222-3001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center