Healthcare Provider Details

I. General information

NPI: 1578381596
Provider Name (Legal Business Name): AVR LAB SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2024
Last Update Date: 09/30/2024
Certification Date: 09/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6208 STORNOWAY DR. S.
COLUBMUS OH
43213
US

IV. Provider business mailing address

6208 STORNOWAY DR. S.
COLUBMUS OH
43213
US

V. Phone/Fax

Practice location:
  • Phone: 614-974-3344
  • Fax: 614-417-1445
Mailing address:
  • Phone: 614-974-3344
  • Fax: 614-417-1445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246QL0900X
TaxonomyLaboratory Management Specialist/Technologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VALARIE ROBINSON
Title or Position: SPECIMEN COLLECTOR, OWNER
Credential:
Phone: 614-974-3344