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General NPI Number Information
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NPI Number | 1255084935
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Entity Type | Organization
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Legal Business Name | LA DOT DRUG TESTING CENTER LLC
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Dates
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Enumeration Date | 02/01/2022
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Last Update Date | 02/01/2022
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Provider Practice Location Address
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Address Line | 411 E 5TH ST
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City | DAYTON
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State | OH
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Zip | 45402-2957
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Country | US
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Telephone | 937-504-9889
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Fax | 800-889-1070
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Provider Business Mailing Address
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Address Line | 1044 STOLZ AVE
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City | DAYTON
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State | OH
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Zip | 45417-4257
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Country | US
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Telephone | 937-504-9889
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Fax | 800-889-1070
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Authorized Official
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Title or Position | OWNER
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Name | RENOTTA BROWN
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Credential |
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Telephone | 937-504-9889
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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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