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General NPI Number Information
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NPI Number | 1316547474
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Entity Type | Organization
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Legal Business Name | UNITED MEDICAL LAB LLC
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Dates
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Enumeration Date | 10/28/2020
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Last Update Date | 10/28/2020
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Provider Practice Location Address
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Address Line | 3201 EASTON AVE
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City | CHATTANOOGA
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State | TN
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Zip | 37415-4715
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Country | US
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Telephone | 270-683-7991
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Fax |
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Provider Business Mailing Address
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Address Line | 3201 EASTON AVE
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City | CHATTANOOGA
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State | TN
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Zip | 37415-4715
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Country | US
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Telephone | 270-683-7991
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | JACOB SHAH
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Credential |
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Telephone | 270-683-7991
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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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