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General NPI Number Information
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NPI Number | 1386915700
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Entity Type | Organization
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Legal Business Name | LABTECH DIAGNOSTIC, LLC
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Dates
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Enumeration Date | 01/17/2012
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Last Update Date | 03/18/2014
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Provider Practice Location Address
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Address Line | 1502 E GREENVILLE ST
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City | ANDERSON
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State | SC
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Zip | 29621-2005
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Country | US
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Telephone | 864-760-0039
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Fax | 864-760-0051
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Provider Business Mailing Address
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Address Line | 1502 E GREENVILLE ST
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City | ANDERSON
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State | SC
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Zip | 29621-2005
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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 | PRESIDENT/OWNER
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Name | MR. ALYOSEF LABASHABAZID
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Credential |
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Telephone | 864-760-0039
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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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