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General NPI Number Information
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NPI Number | 1336809862
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Entity Type | Organization
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Legal Business Name | QUANTUM LABORATORY SERVICES LLC
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Dates
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Enumeration Date | 12/24/2021
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Last Update Date | 12/02/2022
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Provider Practice Location Address
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Address Line | 824 N CREEK DR
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City | CONWAY
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State | AR
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Zip | 72032-4711
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Country | US
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Telephone | 800-733-4305
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Fax |
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Provider Business Mailing Address
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Address Line | 824 N CREEK DR
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City | CONWAY
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State | AR
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Zip | 72032-4711
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Country | US
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Telephone | 800-733-4305
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MELANIE ANN HOGREFE
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Credential |
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Telephone | 800-733-4305
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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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