Healthcare Provider Details

I. General information

NPI: 1750954467
Provider Name (Legal Business Name): YOUR TIME LABS AND MORE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2021
Last Update Date: 07/20/2021
Certification Date: 07/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 WESTOVER PINES DR
RICHMOND VA
23223-3458
US

IV. Provider business mailing address

430 WESTOVER PINES DR
RICHMOND VA
23223-3458
US

V. Phone/Fax

Practice location:
  • Phone: 804-245-7064
  • Fax:
Mailing address:
  • Phone: 804-245-7064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State

VIII. Authorized Official

Name: MRS. SADAWN GOODE MOORE
Title or Position: OWNER
Credential: CPT
Phone: 824-245-7064