MEDICARE: RX INNOVATIONS, LLC, DBA FIRSTLAB OF VIRGINIA

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	2005-108709-R	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	145016	OTHER	VA	ANTHEM BC/BS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952348757
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RX INNOVATIONS, LLC, DBA FIRSTLAB OF VIRGINIA

Provider Business Mailing Address
First Line	:	1701 WILL O WISP DR
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-3102
Country	:	US
Telephone Number	:	757-412-3273
Fax Number	:	757-412-6464

Provider Business Practice Location Address
First Line	:	1701 WILL O WISP DR
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-3102
Country	:	US
Telephone Number	:	757-412-3273
Fax Number	:	757-412-6464

Authorized Official
Title or Position	:	ADMINISTRATIVE DIRECTOR
Name	:	MR. THOMAS ARNOLD FISCHER
Credential	:	MS MT(ASCP)
Telephone Number	:	757-412-3273

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	08/22/2020

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Directions to “RX INNOVATIONS, LLC, DBA FIRSTLAB OF VIRGINIA ” Practice Location

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