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General NPI Number Information
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NPI Number | 1043650617
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Entity Type | Organization
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Legal Business Name | LAB ONE LLC
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Dates
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Enumeration Date | 06/27/2013
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Last Update Date | 02/24/2015
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Provider Practice Location Address
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Address Line | 211 S 3RD ST
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City | LOUISIANA
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State | MO
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Zip | 63353-2000
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Country | US
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Telephone | 573-754-3183
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 ADAMS AVE MRGOV 2ND FLOOR
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City | NORRISTOWN
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State | PA
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Zip | 19403-2429
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Country | US
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Telephone | 484-676-7000
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | J PABLO LAKE
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Credential |
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Telephone | 484-676-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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