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General NPI Number Information
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NPI Number | 1275018871
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Entity Type | Organization
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Legal Business Name | LAB24, LLC
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Dates
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Enumeration Date | 09/28/2018
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Last Update Date | 06/20/2019
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Provider Practice Location Address
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Address Line | 475 KNOLLCREST DR
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City | REDDING
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State | CA
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Zip | 96002-0101
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Country | US
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Telephone | 530-319-7222
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Fax | 530-319-7225
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Provider Business Mailing Address
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Address Line | 475 KNOLLCREST DR
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City | REDDING
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State | CA
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Zip | 96002-0101
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Country | US
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Telephone | 530-319-7222
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Fax | 530-319-7225
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Authorized Official
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Title or Position | OWNER
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Name | JOHN SERLE
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Credential |
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Telephone | 530-319-7222
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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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