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General NPI Number Information
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NPI Number | 1326849563
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Entity Type | Organization
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Legal Business Name | KVJ ROYAL LAB
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Dates
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Enumeration Date | 03/24/2025
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 5000 THAYER CTR STE C
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City | OAKLAND
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State | MD
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Zip | 21550-1139
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Country | US
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Telephone | 346-424-9548
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Fax | 866-487-1705
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Provider Business Mailing Address
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Address Line | 3904 CORBIN PL
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City | BOWIE
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State | MD
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Zip | 20715-1653
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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 | OFFICE MANAGER
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Name | KRYTISEYA JORDAN-WORTHY
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Credential |
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Telephone | 240-354-8918
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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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