Healthcare Provider Details

I. General information

NPI: 1679348973
Provider Name (Legal Business Name): METICULOUS LABS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2023
Last Update Date: 11/17/2023
Certification Date: 11/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5865 RIDGEWAY CENTER PKWY STE 300
MEMPHIS TN
38120-4014
US

IV. Provider business mailing address

1910 MADISON AVE # 2619
MEMPHIS TN
38104-2620
US

V. Phone/Fax

Practice location:
  • Phone: 901-621-3500
  • Fax: 901-665-7416
Mailing address:
  • Phone: 901-621-3500
  • Fax: 901-665-7416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: DEPAULA ARNIT GLOVER ROSS
Title or Position: LAB DIRECTOR
Credential: CPT
Phone: 901-621-3500