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General NPI Number Information
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NPI Number | 1538819610
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Entity Type | Organization
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Legal Business Name | QUICK STOP LABORATORY
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Dates
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Enumeration Date | 03/24/2022
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Last Update Date | 03/24/2022
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Provider Practice Location Address
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Address Line | 9551 ATLANTIC BLVD SUITE 466
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City | JACKSONVILLE
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State | FL
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Zip | 32225
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Country | US
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Telephone | 877-857-8425
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Fax |
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Provider Business Mailing Address
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Address Line | 9551 ATLANTIC BLVD SUITE 466
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City | JACKSONVILLE
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State | FL
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Zip | 32225
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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 | OWNER
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Name | LANEISHA BYRD
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Credential | NURSE
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Telephone | 904-554-9015
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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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