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General NPI Number Information
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NPI Number | 1710641907
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Entity Type | Organization
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Legal Business Name | AB LAB & DIAGNOSTICS LLC
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Dates
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Enumeration Date | 10/25/2021
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Last Update Date | 01/28/2022
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Provider Practice Location Address
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Address Line | 5475 BROADWAY
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City | MERRILLVILLE
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State | IN
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Zip | 46410-1647
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Country | US
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Telephone | 800-318-2900
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Fax |
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Provider Business Mailing Address
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Address Line | 5475 BROADWAY
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City | MERRILLVILLE
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State | IN
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Zip | 46410-1647
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Country | US
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Telephone | 800-318-2900
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. BRITNEY BYNUM
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Credential | BSN, RN
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Telephone | 800-318-2900
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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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Taxonomy #2
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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