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General NPI Number Information
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NPI Number | 1558015933
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Entity Type | Organization
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Legal Business Name | ONE CALL AWAY LABS SERVICES
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Dates
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Enumeration Date | 02/04/2022
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Last Update Date | 02/04/2022
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Provider Practice Location Address
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Address Line | 13720 OLD SAINT AUGUSTINE RD STE 8-236
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City | JACKSONVILLE
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State | FL
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Zip | 32258-7414
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Country | US
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Telephone | 866-974-6632
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Fax | 866-974-6632
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Provider Business Mailing Address
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Address Line | 13720 OLD SAINT AUGUSTINE RD STE 8-236
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City | JACKSONVILLE
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State | FL
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Zip | 32258-7414
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Country | US
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Telephone | 866-974-6632
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Fax | 866-974-6632
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | MS. LATASHA RENEE BURGESS
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Credential |
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Telephone | 866-974-6632
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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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