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General NPI Number Information
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NPI Number | 1174495220
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Entity Type | Organization
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Legal Business Name | HOMETOLAB DIAGNOSTIC SERVICES LLC
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Dates
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Enumeration Date | 09/18/2025
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Last Update Date | 11/02/2025
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Provider Practice Location Address
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Address Line | 243 ARLINGTON RD N
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City | JACKSONVILLE
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State | FL
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Zip | 32211-7857
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Country | US
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Telephone | 727-473-5834
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Fax |
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Provider Business Mailing Address
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Address Line | 243 ARLINGTON RD N STE 1B
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City | JACKSONVILLE
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State | FL
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Zip | 32211-7869
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Country | US
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Telephone | 727-473-5834
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER HUDSON
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Credential |
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Telephone | 727-473-5834
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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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