=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598627515
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LABS 2 GO
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/28/2025
-----------------------------------------------------
Last Update Date | 12/01/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 770 STONEWALL ST
-----------------------------------------------------
City | MEMPHIS
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38107-4444
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 901-290-7353
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 770 STONEWALL ST
-----------------------------------------------------
City | MEMPHIS
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38107-4444
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 901-290-7353
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | FREDRICK BROOKS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 662-705-3217
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 246RP1900X
-----------------------------------------------------
Taxonomy Name | Phlebotomy Technician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------