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General NPI Number Information
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NPI Number | 1255019113
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Entity Type | Organization
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Legal Business Name | COEY LABS LLC
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Dates
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Enumeration Date | 07/10/2023
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 216 W FIESTA KEY LOOP
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City | DELAND
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State | FL
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Zip | 32720-3986
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Country | US
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Telephone | 386-845-4022
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Fax |
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Provider Business Mailing Address
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Address Line | 216 W FIESTA KEY LOOP
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City | DELAND
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State | FL
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Zip | 32720-3986
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | TERRANCE WARD
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Credential | DC
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Telephone | 386-845-4022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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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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