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General NPI Number Information
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NPI Number | 1699527804
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Entity Type | Organization
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Legal Business Name | DREAM LAB DRUG AND ALCOHOL TESTING
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Dates
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Enumeration Date | 04/02/2024
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Last Update Date | 04/02/2024
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Provider Practice Location Address
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Address Line | 138 E. PEELER AVE SUIT-277
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City | SHAW
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State | MS
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Zip | 38773
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Country | US
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Telephone | 833-537-3262
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Fax | 818-855-7826
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Provider Business Mailing Address
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Address Line | P.O BOX 277 138 E. PEELER AVE SUIT-277
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City | SHAW
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State | MS
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Zip | 38773
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Country | US
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Telephone | 833-537-3262
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Fax | 818-855-7826
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Authorized Official
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Title or Position | CEO
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Name | MISS SHEKENDRA PATTY BRYANT
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Credential |
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Telephone | 833-537-3262
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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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