Healthcare Provider Details
I. General information
NPI: 1982369989
Provider Name (Legal Business Name): FIRST CHOICE LAB SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/03/2021
Last Update Date: 11/03/2021
Certification Date: 11/03/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1515 E SILVER SPRINGS BLVD # 101.1
OCALA FL
34470-6831
US
IV. Provider business mailing address
1255 NE 12TH PL
OCALA FL
34470-5531
US
V. Phone/Fax
- Phone: 877-491-2212
- Fax:
- Phone: 352-691-0118
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 247ZC0005X |
| Taxonomy | Clinical Laboratory Director (Non-physician) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
CHANTEL
JOHNSON
Title or Position: OWNER
Credential:
Phone: 877-491-2212