Healthcare Provider Details

I. General information

NPI: 1679241418
Provider Name (Legal Business Name): AMERICAN LABORATORY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2021
Last Update Date: 09/04/2021
Certification Date: 09/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 FREIDRICH LN STE G-1
AUSTIN TX
78744-1800
US

IV. Provider business mailing address

4150 FREIDRICH LN STE G-1
AUSTIN TX
78744-1800
US

V. Phone/Fax

Practice location:
  • Phone: 512-256-3703
  • Fax:
Mailing address:
  • Phone: 618-402-6818
  • Fax:

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: RACHELLE RUSSELL
Title or Position: CEO
Credential:
Phone: 512-256-3703