Healthcare Provider Details

I. General information

NPI: 1346774023
Provider Name (Legal Business Name): CARDIO LAB SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2017
Last Update Date: 04/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 HIOAKS RD SUITE D
RICHMOND VA
23225-4038
US

IV. Provider business mailing address

909 HIOAKS RD SUITE D
RICHMOND VA
23225-4038
US

V. Phone/Fax

Practice location:
  • Phone: 804-292-0968
  • Fax:
Mailing address:
  • Phone: 804-292-0968
  • 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: MR. LARRY DENSON JR.
Title or Position: OWNER/ PRESIDENT
Credential: RCS
Phone: 804-292-0968