Healthcare Provider Details

I. General information

NPI: 1609546837
Provider Name (Legal Business Name): VELOCITY LAB SERVICES L.L.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2021
Last Update Date: 11/30/2023
Certification Date: 11/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5218 JAMMES ROAD BUILDING A STE. 1
JACKSONVILLE FL
32210-1475
US

IV. Provider business mailing address

5218 JAMMES ROAD BUILDING A STE. 1
JACKSONVILLE FL
32210-1475
US

V. Phone/Fax

Practice location:
  • Phone: 904-868-0166
  • Fax: 888-603-5447
Mailing address:
  • Phone: 904-868-0166
  • Fax: 888-603-5447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: RITHA WASHINGTON-MCFARLEY
Title or Position: OWNER/ADMINISTRATOR
Credential:
Phone: 904-947-0766