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General NPI Number Information
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NPI Number | 1467178574
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Entity Type | Organization
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Legal Business Name | AR JOURNEY LAB, LLC
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Dates
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Enumeration Date | 10/19/2022
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Last Update Date | 10/19/2022
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Provider Practice Location Address
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Address Line | 3111 MILITARY RD
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City | BENTON
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State | AR
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Zip | 72015-2723
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Country | US
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Telephone | 501-204-8749
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Fax | 501-295-3232
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Provider Business Mailing Address
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Address Line | 3111 MILITARY RD
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City | BENTON
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State | AR
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Zip | 72015-2723
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Country | US
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Telephone | 501-204-8749
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Fax | 501-295-3232
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Authorized Official
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Title or Position | OWNER
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Name | HEATHER MASON
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Credential |
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Telephone | 501-204-8749
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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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