Healthcare Provider Details

I. General information

NPI: 1134092471
Provider Name (Legal Business Name): 850 LABS TO GO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2025
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6954 W HIGHWAY 98 APT 2-102
PANAMA CITY BEACH FL
32407-5433
US

IV. Provider business mailing address

6954 W HIGHWAY 98 APT 102
PANAMA CITY BEACH FL
32407-5459
US

V. Phone/Fax

Practice location:
  • Phone: 850-630-2667
  • Fax: 754-339-0030
Mailing address:
  • Phone: 850-630-2667
  • Fax: 754-339-0030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247ZC0005X
TaxonomyClinical Laboratory Director (Non-physician)
License Number
License Number State

VIII. Authorized Official

Name: MS. CASSIDY ROSE BACON
Title or Position: CEO, CFO, DIRECTOR, COLLECTOR
Credential: CPT, CCMA
Phone: 850-630-2667