MEDICARE: BABSON DIAGNOSTICS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	45D2161710	OTHER		CLIA
2	8505954	OTHER		CAP

General Provider Information

NPI Number	:	1548996762
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BABSON DIAGNOSTICS, INC.

Provider Business Mailing Address
First Line	:	1321 RUTHERFORD LN STE 200
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78753-6739
Country	:	US
Telephone Number	:	512-709-9139
Fax Number	:

Provider Business Practice Location Address
First Line	:	1321 RUTHERFORD LN STE 200
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78753-6739
Country	:	US
Telephone Number	:	512-709-9139
Fax Number	:

Authorized Official
Title or Position	:	LABORATORY DIRECTOR
Name	:	JAMES W JACOBSON
Credential	:
Telephone Number	:	512-965-1497

Provider Enumeration Date	:	07/29/2022
Last Update Date	:	03/10/2026

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