Healthcare Provider Details

I. General information

NPI: 1407765753
Provider Name (Legal Business Name): AZLABS2GO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 S WATSON RD
BUCKEYE AZ
85326-6303
US

IV. Provider business mailing address

1300 S WATSON RD
BUCKEYE AZ
85326-6303
US

V. Phone/Fax

Practice location:
  • Phone: 623-304-5580
  • Fax: 623-234-8981
Mailing address:
  • Phone: 623-304-5580
  • Fax: 623-234-8981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State

VIII. Authorized Official

Name: TIARENCE BANDA
Title or Position: OWNER/ CERTIFIED PHLEBOTOMIST
Credential: CPT
Phone: 623-304-5580