Provider Demographics
NPI:1477173847
Name:AUGUSTUS LABS LLC
Entity type:Organization
Organization Name:AUGUSTUS LABS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JABER
Authorized Official - Middle Name:
Authorized Official - Last Name:NIKNAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-758-2616
Mailing Address - Street 1:2801 FINLEY RD STE 101
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1039
Mailing Address - Country:US
Mailing Address - Phone:630-672-8100
Mailing Address - Fax:630-672-8100
Practice Address - Street 1:2801 FINLEY RD STE 101
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-1039
Practice Address - Country:US
Practice Address - Phone:630-672-8100
Practice Address - Fax:630-672-8100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-25
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory